Download in the name of god faraji.z.md

IN THE NAME OF GOD
FARAJI.Z.MD
ADDITIONAL SPECIAL TEST
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The special tests performed at this phase should
be used to further differentiate between
pathological and normal tissue
suspect to be pathological based on the findings
SEVERAL TYPES OF SPECIAL TESTS
. Joint stability tests
integrity of the inert joint tissues, specifically
the joint capsule and ligaments (ex:ant drawer
test)
 Joint compression test
inert joint tissues that line the joint surface,
such as the articular cartilage and meniscus
(McMurray’s)
 anthropometric assessments
(general body structure/ body composition
assessment)
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NEUROLOGICAL TESTING
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1.
2.
3.
unexplained loss of strength, paresthesia, or
numbness, or has sustained an injury to the
vertebral region
sensory (dermatomes)
motor (myotomes),
reflex (deep tendon, superficial, and
pathological reflexes)
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spinal nerve roots and peripheral nerves
Other
cranial nerve assessment,
neuropsychological assessment (cognitive
ability
cerebellar function (coordinated movements:
finger to nose)
DERMATOME TESTING.
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innervated by a specific nerve root
bilateral comparison
sharp and dull discrimination, hot and cold
discrimination, and two-point discrimination to
assess peripheral nerve injury
DERMATOME TESTING.
MYOTOME TESTING.
REFLEX TESTING.
deep tendon reflexes,
 superficial reflexes,
 pathological reflexes
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DEEP TENDON REFLEXES
SUPERFICIAL REFLEXES
Upper abdominal
 Lower abdominal
 cremasteric,
 plantar,
 gluteal.
 Anal reflexes
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PATHOLOGICAL REFLEXES
Upper motor neuron
 Lower motor neuron
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NEUROLOGICAL TEST FINDING
 nerve
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root compression,
nerve root stretch,
motor neuron lesion
FUNCTIONAL SCREENING TESTS
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Part of the preparticipation physical examination
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Trainer observe movement
OVERHEAD AND SINGLE LEG SQUAT TESTS
LANDING ERROR SCORING SYSTEM
TUCK JUMP TEST
FUNCTIONAL MOVEMENT SCREEN
bridge the gap between preparticipation exams
and performance testing /fundamental movement
Deep squat
 Hurdle step
 In-line lunge
 Shoulder mobility test
 Active straight-leg raise
 Trunk stability pushup
 Rotary stability test
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SOAP NOTES
 S(Subjective)
0
(Objective)
 A (Assessment)
 P (Plan)
SETTING REHABILITATION GOALS
Rehabilitation goals should be included as part of
the treatment plan in the SOAP note
 The rehabilitation goals should be based upon
the information gathered during the evaluation
and should address signs and symptoms recorded
in the SOAP note
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SHORT-TERM GOALS
Decrease swelling by 30 percent within 4 days
 Increase active range of motion by 50 percent
within 1 week
 Progress to full weight bearing during walking
gait within 1 week
 Reduce acute pain by 50 percent within 4 days
 Increase eversion ankle strength by 50 percent
in 4 days
 Increase plantar flexion ankle strength by 50
percent in 4 days
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LONG-TERM GOALS
Return to limited practice using protective tape
support within 2 weeks
 Return to full practice using protective tape
support within 2.5 weeks
 Return to full competition using protective
taping within 3 weeks
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PROGRESS EVALUATIONS
The progress evaluation should be based on the
athletic trainer's knowledge of exactly what is
occurring in the healing process at any given
time
 To ensure that the progress evaluation will be
complete. it is still necessary to go through
certain aspects of history, observation, palpation,
and special testing
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HISTORY
How is the pain today, compared to yesterday?
 Is the patient able to move better and with less
pain?
 Does the patient feel that the treatment done
yesterday helped or made him sorer?
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OBSERVATION
How is the swelling today? More or less than
yesterday?
 Is the patient able to move better today?
 Is the patient still guarding and protecting the
injury?
 How is the patient's attitude—upbeat and
optimistic, or depressed and negative?
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PALPATION
Does the swelling have a different consistency
today, and has the swelling pattern changed?
 Is the injured structure still as tender to touch?
 Is there any deformity present today that was
not as obvious yesterday?
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SPECIAL TESTS
Does ligamentous stress testing cause as much
pain, or has assessment of the grade of instability
changed?
 How does a manual muscle test compare with
yesterday?
 Has either active or passive range of motion
changed?
 Does accessory movement appear to be limited?
 Can the patient perform a specific functional test
better today than yesterday?
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PROGRESS NOTES
SOAP format
 in the form of an expanded treatment note, or
may be done as a weekly summary
 types of treatment
 short-term goals
 the course of treatment over the next several
days
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THANKS FOR YOUR
ATTENTION