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Mercer County Community College Physical Therapist Assistant Program Course Handbook PTA 106 Therapeutic Measurement Summer 2004 MaryLouise Jani, PT, MS MS 161 Course Director 586-4800 x 3329 [email protected] Mercer County Community College Physical Therapist Assistant Program Course Syllabus Form =============================================================== Course #: PTA 106 Course Title: Therapeutic Measurement Credit Hours:(Lecture/Lab) 1 0/2 Contact Hours during the semester: 24 Number of weeks: 6 Clinical Contact Hours during the semester: 0 Number of clinical weeks: 0 Pre-/co-requisite courses: Grading: PTA 101 Intro to PTA 50 % exams(#) 5 PTA 105 Kinesiology NA % quizzes (#) NA % paper(s) NA % presentation(s) 10 % class/lab participation 30 % practical exam 10 % competency tests =============================================================== Text(s): Required: Clarkson, Gilewich. Musculoskeletal Assessment: Joint ROM & Muscle Strength, Williams & Wilkins, Baltimore, 1989. Optional Kendall, McCreary, Provance, Muscles Testing & Function 4th Ed., Williams & Wilkins, Baltimore, 1993. frequent use of ADAM Software in MS Computer Lab =============================================================== Course Description: This course is restricted to Physical Therapist Assistant students ONLY. It is a required course for PTA majors. It is a laboratory course designed to develop measurement skills for joint Range of Motion (ROM), and muscle strength for all the peripheral joints. Course material will also develop student skills for volumetric, circumferential and posture assessments and documentation skills. Students will be performing manual muscle tests (MMTs), and ROM measurements utilizing a goniometer. Students will be tested for competence to perform the assessments on their classmates. =============================================================== 2 Course Objectives: Following the completion of this course with a grade of “C” or higher, the student will possess skills in the following domains: Cognitive/Knowledge The student will be able to successfully: 1. identify synergistic muscle groups that initiate and continue motion for the peripheral joints 2. differentiate between gravity assisted, resisted and eliminated testing positions for MMTs 3. identify muscles that will try to substitute for weak muscles to maintain or perform a specified motion 4. differentiate between the advantages & disadvantages of various measurement techniques for strength, ROM and extremity size or volume 5. identify the components of measurements that need to be documented in a patient chart 6. recognize normal and abnormal joint movement 7. describe the difference between active and passive ROM Psychomotor The student will be able to successfully: 1. perform manual muscle tests for all grades for the prime movers 2. perform goniometric measurement of joint range of motion for all peripheral joints 3. perform a volumetric measurement for the hand and foot/ankle 4. perform circumferential measurements for an upper extremity 5. perform a postural assessment for a seated and standing patient 6. document objective measurements in the patient chart 7. recognize normal and abnormal muscle length 8. perform goniometric measurement of muscle length for specific muscles 9. perform passive ROM for all peripheral joints Affective The student will be able to successfully: 1. defend the importance of licensed clinicians performing and documenting ROM, MMTs and volumetric measurements 2. recognize the importance of explaining measurements in a manner that the patient can understand 3. defend the inclusion of objective measurements in a patient chart =============================================================== Course Outline: I Measurement of Range of Motion A. Tools 1. Visual observations 2. Patient Positioning 3. Palpation 3 4. Goniometer a. components 5. Position 6 “Eyeball” concepts B. Types of Motion 1. passive 2. active 3. active assisted 4. resisted II Manual Muscle Testing A. Positions 1. Gravity a. assisted b. eliminated B. Muscle grading C. Muscle strengthening concepts III Volumetric assessment A. Tools 1. Volumeter 2. Tape measure IV Documentation A. Goniometry B. Manual Muscle Tests C. Volume & Girth measurements =============================================================== Course Schedule: Summer 2004 T & R: 9-11, 1-3 =============================================================== PTAP Policy: Course Grading One of the goals of the MCCC PTAP is to prepare students to practice as PTAs. In New Jersey, as in many other states, PTAs are required to be licensed. Licensure is granted following the successful completion of a standardized licensing exam, with a score of 75 or higher. In recognition of this standard, set by a board that is external to MCCC, the PTAP will adopt 75 as the minimal passing grade. Other grade ranges are as follows: A= B= 93-100 84-92 C= D= 75-83 70-74 F= below 70 Grades below 75 are not considered passing grades for PTAP courses, and are therefore considered unacceptable. All PTAP courses must be completed with a grade of “C” or higher. All course grade determinations are made by the course director for that course. 4 PTAP Attendance and Deportment Policy Statements Physical Therapy is a respected profession. Members of the profession abide by the Code of Ethics for Professional Conduct and the Guide for Professional Conduct. The MCCC PTAP faculty believe that professional conduct and deportment are essential components for success as a Physical Therapist Assistant. Enrollment in a PTAP course will be viewed as a commitment that is made between the student and the instructor. Enrollment in PTAP courses is viewed as a similar agreement to the one that exists between an employer and an employee. Both parties agree and understand that: Attendance is expected for every scheduled lecture, laboratory and clinical education course. Excused absences of didactic courses may be permitted at the discretion of the Course Director, if the absence is discussed in advance of the occurrence. It is the responsibility of the student to leave a message with the PTA Program Coordinator, Barbara Behrens if the student is going to be absent from a scheduled lecture, laboratory or clinical education course (609-5864800x 33853). This message is to be left prior to the absence of the student. Lateness to a scheduled lecture, laboratory or clinical education course in unacceptable. The student and the Course Director will negotiate based upon the frequency and circumstances, to determine what action will be taken. Repeated lateness may adversely effect student performance and progression within the PTAP. Students and faculty are expected to behave at all times, in a manner that is consistent with the behaviors of their chosen profession and those of a civilized society.(Nothing in this statement should be construed to prohibit an individual from having an individual lifestyle outside of the clinic environment that may differ from the expected behaviors in the clinic or classroom.) Failure to exhibit behaviors consistent with this policy may result in the need for Program counseling to determine the appropriateness of the choice of major. Continued matriculation following acceptance in the PTAP indicates that the student has agreed to accept and uphold their commitment to these policies. 5 Students with documented disabilities may request modifications, accommodations, or auxiliary aids which will enable them to participate in and benefit from all program educational activities. If you feel that this applies to you, make an appointment to meet with the PTA program coordinator to discuss your needs, prior to the first quiz, exam or other assignment for the course. 6 Mercer County Community College Physical Therapist Assistant Program Confidentiality Expectations Patients: During the academic preparation to become a physical therapist assistant, there will be instances when you will be expected to collect data regarding a patient that you have seen or are seeing. This data is intended to be used for educational purposes only. Under NO circumstances, should this data be identified with a particular patient or individual by the use of proper names. Sample acceptable data for collection: diagnosis prescribed medications age, gender overall medical condition of the patient previous medical history physical therapy plan of care record of PT visits physical therapy documentation Classmates: Periodically during the course of the semester, individuals among your classmates may be asked to share physical anomalies or previous injuries and treatments with the PTAP class. If an individual chooses to share this information with the class, it is NOT to leave the classroom. If an individual does not wish to share a personal diagnosis or anomaly with the class, it is within their rights not to do so. Volunteers will be solicited for laboratory demonstrations. Information obtained during these lab exercises is intended for demonstration purposes only. It is the right of every individual NOT to volunteer for a demonstration. However, all students are expected to volunteer to be a patient for their classmates. This may involve the removal of minor articles of clothing. In the event that clothing is removed, draping techniques will be employed to preserve patient dignity. Faculty: Any and all individuals who elect to allow themselves to be the patient during class and lab activities can expect that all information gained during the activity will remain confidential. This extends to all MCCC faculty and MCCC staff who elect to be “patients”. 7 Mercer County Community College Physical Therapist Assistant Program PTA 106 Therapeutic Measurement Summer 2004 Tuesday & Thursday 9:00 – 11:00 AM & Tuesday & Thursday 1:00 – 3:00 PM in MS 352 Date Topic(s) Reading 5/25 Tools of Measurement Clarkson, Chapter 1 Kendall, Chapter 1 5/27 Tools of Measurement Clarkson, Chapter 1 Kendall, Chapter 2 6/1 Cervical & Trunk ROM WE#1 Clarkson, Chapter 2 Kendall, Chapters 4 & 5 6/3 Shoulder ROM 6/8 Shoulder ROM WE#2 Clarkson, Chapter 3 Kendall, Chapters 8 & 10 Clarkson, Chapter 3 Kendall, Chapters 8 & 10 6/10 Elbow, Wrist & Hand ROM Clarkson, Chapters 4 & 5 Kendall, Chapter 8 & 10 6/15 Hip, Knee & Ankle ROM WE#3 Clarkson, Chapters 6, 7 & 8 Kendall, Chapter 7 6/17 Upper Extremity MMT Clarkson, Chapters 3,4 & 5 Kendall, Chapters 8 & 10 6/22 Upper Extremity MMT WE#4 Clarkson, Chapters 3, 4 & 5 Kendall, Chapters 8 & 10 6/24 Lower Extremity MMT Clarkson, Chapters 6, 7 & 8 Kendall, Chapters 7 & 11 6/29 Lower Extremity MMT WE#5 Clarkson, Chapters 6, 7 & 8 Kendall, Chapters 7 & 11 7/1 PRACTICAL EXAM 8 Mercer County Community College Physical Therapist Assistant Program Competence = adequacy, fitness Competent = capable, fit, qualified Competency Testing The focus of all health related professions is the patient. As health care providers and educators, we are striving to assure that the safety of our patient is not compromised in any way by the actions of our students. All PTA program laboratory courses involve direct interaction between the students and the PTA faculty. All PTA students experience both administering care and receiving care, classmates are both “patients” and “clinicians”. PTA laboratory courses also involve individualized competency testing for specified skills that have been identified as entry level skills students should possess. Competency testing presents a method of assuring the clinical community that the PTA student is competent and safe to perform procedures and techniques with patients. What is a competency test? a 15 or 30 minute “appointment” made by the student with a clinician tester an opportunity for the student to demonstrate their skill level by performing the identified procedures on a fellow classmate in the presence of a tester a method for the clinician tester to assure competence, safety, and skill level for a specific procedure or technique. Competency Tests are Composed of: 1. 2. 3. 4. course # course title title of the test objectives for the test which include preparation of the patient and the treatment area observation of the indications, contraindications & precautions implementation of the procedure or technique termination or completion of the technique or procedure documentation of what was observed, performed, and or measured and pre/post assessments questions clinical or medical complications and the impact that they might have on the procedure or technique to be performed. (“what if” questions) How do students “sign up” for Competency Tests? A notebook labeled “PTAP Competency Testing” is located on the bookshelf inside MS352. The notebook has a calendar of available testing times for students to select from. How do students prove that they have been tested and are “competent” to perform a particular task? Students have a “Sign Off Sheet” that they are responsible for having their clinician tester sign once the objectives for the test have been satisfied. Once the “Sign Off Sheet” is complete for a given course, the students return the form to the PTA program coordinator. All tests for a given course must be completed and the “Sign Off Sheet” must be turned in to the PTA program coordinator to establish eligibility to take the practical exam for a course. 9 Where would a student find information about competency tests for a particular course? Course handbooks have a copy of the requirements for the course. A listing of the competency tests and their content can be found in every course that has a laboratory component to it. What remedy is there for a student who does not successfully complete a competency test on the first try? Students are encouraged to sign up for a test only when they feel that they are competent. Clinician testers work with students to help them refine their skills if the “basics are there, but a little rough around the edges”. The responsibility for successful completion of the tests increases as the student progresses through the PTA curriculum. In PTA 106- Therapeutic Measurement, students may retake a competency test as often as they need until both the tester and the student feel that the student is competent to perform the procedure. In subsequent PTA laboratory courses, the student is capable of retaking the competency test as many times as they need, however, points will be deducted for each unsuccessful attempt. What is the difference between a practical exam and a competency test? During a competency test: the tester interacts freely with the student being tested. the student may ask for clarification from the tester. the student may submit their documentation the day after the test has been completed. Students sign up for competency tests when they feel that they are ready to take them. Students know exactly what test they will be demonstrating competence with. During a practical exam: the tester does not interact with the student, they take notes. the tester provides no additional information to the student being tested. the documentation for the test is due at the completion of the test. Students are assigned a specific testing time. Students select a patient problem at the time of the test. They do not know the content of the problem in advance. 10 Mercer County Community College Physical Therapist Assistant Program Competency Testing Competency is a form of testing within the MCCC PTA curriculum laboratory courses. This is a practical technique for testing to ensure that students have mastered an entry level skill, and that they are safe to perform that skill. It is also an opportunity for the tester and student to work together one-on-one to further develop the art of physical therapy. Students will be learning and practicing a variety of skills in the laboratory courses. They will be expected to be able to perform these skills in a context based situation for a tester. The experience is not a rote exercise for duplication of the technique. Students will have a description of what is expected for each of the competency tests, and they will be expected to perform the technique in a given set of circumstances and provide a rationale for why they would perform the technique with a patient. The tester observes the student interacting with their “patient”, noting whether or not the technique is performed safely and whether or not the student demonstrates caring for the patient and an understanding of the technique. Responsibilities of the PTA student: signing up in advance to take a competency test, once they feel that they have mastered the skill. providing a suitable patient to perform the skill with. This is most often a fellow PTAP student, who is dressed in a manner that allows the technique to be performed unrestricted by jewelry or extraneous clothing. preparing and cleaning up the appropriate treatment environment. having the competency tester sign off that they performed the test in a safe and competent manner. Other Information: An individual tester will be assigned for each student competency test. Both the student to be tested and the tester have a copy of what is expected during the competency test. Students who do not perform the skills at a satisfactory level must re-take the test until competence is accomplished to the satisfaction of the tester and the student. 11 Mercer County Community College Physical Therapist Assistant Program Competency Tests: PTA 106 Therapeutic Measurement Testing Tools ObjectivesThe student will successfully be able to demonstrate competence in the following skills: descriptions for each of the listed measurement or testing tools goniometer tape measure volumeter differentiate between the uses for different sizes of goniometers describe the purpose of a volumetric assessment for edema contrast and compare a tape measure with a volumeter for edema assessment demonstrate documentation of measurements taken with a goniometer, a tape measure and a volumeter Cervical & Lumbar ROM ObjectivesThe student will successfully be able to demonstrate competence in the following skills: assessment of postural alignment & symmetry measurement and documentation of cervical ROM flexion/extension, L & R rotation utilizing either a tape measure or a goniometer differentiate between the advantages and disadvantages of the goniometer versus the tape measure measurement and documentation of lumbar ROM flexion/extension, L & R side bending Upper Extremity ROM ObjectivesThe student will successfully be able to demonstrate competence in the following skills: measurement and documentation of: shoulder ROM (within 50 of the tester) 1. flexion/extension 2. internal/external rotation 3. ADD/ABD Horizontal ABD & ADD 4. elbow ROM (within 50 of the tester) 5. flexion/extension forearm ROM (within 50 of the tester) 6. pronation/supination wrist ROM (within 50 of the tester) 7. flexion/extension 8. radial/ulnar deviation 12 Lower Extremity ROM ObjectivesThe student will successfully be able to demonstrate competence in the following skills: measurement and documentation of: Hip ROM (within 50 of the tester) 1. flexion/extension 2. ABDuction/ ADDuction 3. Internal/external rotation Knee ROM (within 50 of the tester) 4. flexion/extension Ankle ROM (within 50 of the tester) 5. dorsi/plantar flexion 6. inversion/eversion Manual Muscle Testing ObjectivesThe student will successfully be able to demonstrate competence in the following skills: assessment and documentation of Manual Muscle Tests (MMT) for: 1. shoulder ABD for a grade of good 2. elbow flexion for a grade of fair 3. wrist extension for grade of fair 4. hip ADD for a grade of normal 5. knee flexion for a grade of good 6. knee extension break test normal 7. ankle dorsiflexion for a grade of trace 8. abdominal muscles trunk flexion good 9. back extensors normal 13 Mercer County Community College Physical Therapist Assistant Program Patient: Practical Examination Score Sheet Student: ___________________ Date: ___________________ 106 Problem: 210 211 & 212 Instructions: You will select one of the possible test scenarios that you will need to perform with an assigned patient. You will make your selection approximately ___ minutes before your actual testing time. During that time, you may review your notes, texts, reference materials, etc., and make notes on a separate piece of paper that you may bring into the test with you. Each test will take a total of ____ minutes to complete. The tester will be looking for the following: (from the individual being tested) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. preparation of the treatment/assessment area for your patient (before and after the session) preparation of yourself, handwashing before touching a patient to see how you introduce yourself to a patient to see that you respect the dignity of your patient to see that you position your patient appropriately for what you are doing with them to see that you explain what you are going to do with the patient to the patient to see that your session and measurements are accurate and in agreement with the testers visual assessment of the measurements and the session to see that you record your session and measurements in a meaningful and accurate manner Patient Safety: to see that you have prioritized what you are going to do with the patient and that you have a physiologically sound and rational plan for the session Patient Safety: to see that you perform the selected tasks with evidence of skill and safety in the techniques performed The tester will be looking for the following from the “patient” during the test: that you do ONLY what you are told to do the you do NOT try to help the clinician that you do NOT ask questions of the tester that you do NOT prepare or clean up the area that you respect the stress of the clinician and do not try to make it more difficult for them to successfully complete the practical Please note: Patient safety is a critical component for the successful completion of this and all PTA program courses within the PTA curriculum. Items 9 & 10 on the list are considered to be skills that must have a score of “8” or higher for the student to pass this practical examination. 14 Scoring 10 = entry level performance for a PTA 9 = competent for a PTA student at this level 8 = frazzled but safe 7 = unsafe or inappropriate 6 = unsafe 1. 5 = fraudulent 4 = disrespectful to the patient 3 = forgotten or incomplete task performance 2= 1= preparation of the treatment/assessment area for your patient (before and after the session) Score: Comments 2. preparation of yourself, handwashing before touching a patient, lab coat and name tag Score: Comments 3. to see how you introduce yourself to a patient (name & title), (clarity and speed) Score: Comments 4. to see that you respect the dignity of your patient (making eye contact at eye level, pt. draping) Score: Comments 5. to see that you position you patient appropriately for what you are doing with them and that you do not have them change positions un-necessarily Score: Comments 6. to see that you explain what you are going to do with the patient to the patient in terms that they will understand Score: Comments 7. to see that your session and measurements are accurate and in agreement with the testers visual assessment of the measurements and the session, recording only what is done and planned Score: Comments 8. to see that you record you session and measurements in a meaningful and accurate manner, using correct abbreviations, spelling and documentation format in black ink Score: Comments 15 9. Patient Safety: to see that you have prioritized what you are going to do with the patient and that you have a physiologically sound and rational plan for the session Score: Comments 10. Patient Safety: to see that you perform the selected tasks with evidence of skill and safety in the techniques performed Score: Comments The following items will be specifically watched by the tester during the test. does the student/patient do ONLY what you are told to do does the student/patient try to help the clinician does the student/patient ask questions of the tester does the patient/student prepare or clean up the area does the student/patient respect the stress of the clinician and does not try to make it more difficult for them to successfully complete the practical If any of these behaviors is observed, points will be deducted from the total score for the patient once they are the clinician. (5 points per observed infraction) Points to be deducted from the patient’s score once they are the clinician: Comments/Infractions: ______________ Total Score for the Clinician: _____________________ Review Date:_________________ Point Deductions (as a patient): _____________________ Student Initials:_______________ Final Score: _____________________ Pass / Fail Tester: ________________________________ Bjb 7/02 16 Mercer County Community College Physical Therapist Assistant Program PTA 106 Therapeutic Measurement Laboratory Exercises Measurement Tools Goniometers (gon- ee- om- eters) Components 1. Examine three goniometers of different sizes. What are the markings on the goniometers? 2. How would you be able to determine the joint “range of motion” with the device? 3. Why do the number of degrees exceed the potential motion possible of a joint? 4. How would you know if you were reading 1800 or 00? 5. Why are the goniometers different lengths? 6. Compare and contrast the materials that the goniometers are made of and their flexibility. Why are some flexible and others not as flexible? 7. What motions for what joints would probably be easier to measure with a flexible goniometer? 8. Examine goniometers made of other materials. How do these goniometers differ from the ones that you purchased? 9. Where might they be most useful? (what joints and what motions) 10. Identify potential uses for each of the goniometers joint most useful for measuring motions for that joint that a particular goniometer would work well for 17 Positioning Clinician 11. Where would you need to be relative to the goniometer to be able to provide the most accurate reading of the measurement tool? Patient 12. How would the patient need to be positioned so that you would be able to allow full ROM of the joint, and accessibility to measure that ROM? Documentation You will be recording joint ROM for various joints and motions. Determine your best position, the patient’s best position and what additional tools you will need. 13. How would you indicate that the patient was not able to start a motion in a neutral position or end ROM for that joint? Tape measures Components 14. Examine the tape measure. What are the available units of measure? 15. Is it firm or does it stretch? 16. Can the surface be cleaned with alcohol? 17. Why would you possibly do this? 18. Is the end of the tape protected? Why would this possibility be a consideration? Select a classmate to have girth measurements for their lower extremity from the popliteal space distally. 19. How frequently (every 1/2”, 1”, 1 1/2”, etc.) do you think that you would need to measure the girth if you were trying to determine if there was edema? 20. What else would you need to do to determine whether or not there was edema? 21. How much tension should there be in the tape? 18 Perform one of the girth measurements and compare your result with the results of one of your classmates. Compare your readings, repeat your readings. Did they change? 22. What would a possible explanation be if there were differences? 23. How would you suggest that differences could be minimized? Positioning Clinician 24. Where should you be in relation to the patient when you are measuring girth? Patient 25. How should the extremity being measured be positioned for measurement? Documentation 26. What information does a tape measure provide you with? 27. How would you record your measurements with a tape measure? 28. What units of measure would you record? How? Volumeters (Vol- ooom-eaters) Components Examine the components of either an upper or lower extremity volumeter. 29. What are they? 30. What do you think they would be used for? 31. How much water would you need? 32. Why? 19 Positioning 33. How would you position your patient if you were measuring the edematous volume of their hand? 34. Their foot? 35. How should you be positioned to record the volumetric measurement? 36. What additional items or tools should you have available to you while performing this type of measurement? Documentation 37. How would you document your findings for volumetric assessment of a hand or foot? 38. How would you know if the extremity was in fact edematous or not? Lab Summary How were the measurement tools similar? What is the difference between the information that you can obtain with a tape measure versus a volumeter? Could a tape measure be utilized to provide any other information than girth or length? If so what? 20 Mercer County Community College Physical Therapist Assistant Program PTA 106 Therapeutic Measurement Laboratory Activities Cervical and Lumbar ROM Tools: Goniometer Which of the cervical ROM measurements do you believe that a goniometer would be most useful for? What is/are the axis/axes of motion for cervical rotation? Is/are it/they palpable? What is the axis of motion for cervical flexion? Is it palpable? What is the axis of motion for lumbar flexion/extension? Is is palpable? Anatomically, what would you align your stationary and moveable arms with? 21 Tape measure Which of the cervical ROM measurements do you believe that the tape measure What would you use as your bony landmarks to measure trunk flexion if you were utilizing a tape measure? Are those bony landmarks palpable? Would trunk side-bending be measurable with a tape measure? If yes, how? What would you need to do to determine if someone’s side bending ROM was limited? Would this be applicable most of the time? Why or why not? 22 Positioning What patient position would seem to make the most sense for measuring cervical ROM? Why? Where do you need to position yourself when measuring cervical ROM? Why? Where would you need to position yourself when measuring trunk or lumbar ROM? Why? Of what significance is the starting position of the patient when performing cervical or trunk or lumbar ROM? Documentation How would you document cervical ROM, trunk ROM, and lumbar ROM? Why? 23 Mercer County Community College Physical Therapist Assistant Program PTA 106 Therapeutic Measurement Laboratory Activities Shoulder Range of Motion Select one of your classmates to be your partner. You will be measuring joint ROM for all motions of the shoulder. You must be able to palpate the bony prominences of the gleno-humoral and scapulo-thoracic joints. Your patient will need to make these areas easily accessible to you. You will also need to be able to visually observe each of the axes of shoulder joint motion. Through use of your text and the classroom demonstrations, record the following information for each of the joints and motions indicated Shoulder patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Flexion Shoulder patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover ABDuction Extension: ADDuction: 24 Shoulder patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Internal rot. Shoulder patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Horizontal ABD External rotation: Horizontal ADD: Comments: 25 Mercer County Community College Physical Therapist Assistant Program PTA 106 Therapeutic Measurement Laboratory Activities Elbow, Forearm, Wrist and Hand Range of Motion Select one of your classmates to be your partner. You will be measuring joint ROM for all motions of the elbow, forearm, wrist and hand. You must be able to palpate the bony prominences of these joints. Your patient will need to make these areas easily accessible to you. You will also need to be able to visually observe each of the axes of joint motion. Through use of your text and the classroom demonstrations, record the following information for each of the joints and motions indicated Elbow: patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Flexion Forearm patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Supination Extension: Pronation: Comments: 26 Wrist patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Flexion Extension: Wrist patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Radial Deviaiton Ulnar Deviation: Hand MCP Flexion 1 2 3 4 5 MCP Extension 1 2 3 4 5 patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Comments: 27 Hand MP Flexion 1 2 3 4 5 MP Extension: 1 2 3 4 5 IP Flexion 1 2 3 4 5 IP Extension: 1 2 3 4 5 patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Hand patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Thumb patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover ABD ADD Comments: 28 Thumb patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Flexion Extension: Comments: 29 Mercer County Community College Physical Therapist Assistant Program PTA 106 Therapeutic Measurement Laboratory Activities Hip, Knee and Ankle Range of Motion Select one of your classmates to be your partner. You will be measuring joint ROM for all motions of the hip, knee and ankle. You must be able to palpate the bony prominences of these joints. Your patient will need to make these areas easily accessible to you. You will also need to be able to visually observe each of the axes of joint motion. Through use of your text and the classroom demonstrations, record the following information for each of the joints and motions indicated Hip: patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Flexion: Extension: Hip: patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover ABD ADD Comments: 30 Hip: patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Internal rot. External rot.: Knee patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Extension Flexion Ankle patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Dorsi Flexion Plantar Flexion Comments: 31 Ankle patient position use of pillows for support draping goniometer axis of rotation stationary arm moveable arm normal ROM measured ROM clinician position prime mover Inversion Eversion Comments: 32 Mercer County Community College Physical Therapist Assistant Program PTA 106 Therapeutic Measurement Laboratory Activities Manual Muscle Testing Upper Extremity Select one of your classmates to be your partner. You will be testing muscle strength for all motions for the of the upper extremity, for grades of Normal, Good, Fair and Trace. You must be able to palpate the bony prominences of these joints. Your patient will need to make these areas easily accessible to you. You will also need to be able to visually observe the muscle belly for each motion. Through use of your text and the classroom demonstrations, record the following information for each of the joints and motions indicated Shoulder: patient position Normal Good Fair Trace draping clinician position prime mover Flexion: Extension: Shoulder: patient position Normal Good Fair Trace draping clinician position prime mover ABD ADD Shoulder: patient position Normal Good Fair Trace draping clinician position prime mover Internal rot. External rot.: 33 Elbow patient position Normal Good Fair Trace draping clinician position prime mover Extension Forearm patient position Normal Good Fair Trace draping clinician position prime mover Supination Wrist patient position Normal Good Fair Trace draping clinician position prime mover Flexion Flexion Pronation Extension Comments: 34 Mercer County Community College Physical Therapist Assistant Program PTA 106 Therapeutic Measurement Laboratory Activities Manual Muscle Tesing Hip, Knee and Ankle Select one of your classmates to be your partner. You will be testing muscle strength for all motions of the hip, knee and ankle. You must be able to palpate the bony prominences of these joints. Your patient will need to make these areas easily accessible to you. You will also need to be able to visually observe each of the axes of joint motion. Through use of your text and the classroom demonstrations, record the following information for each of the joints and motions indicated Hip: patient position Normal Good Fair Trace draping clinician position prime mover Flexion: Extension: Hip: patient position Normal Good Fair Trace draping clinician position prime mover ABD ADD Comments: 35 Hip: patient position Normal Good Fair Trace draping clinician position prime mover Internal rot. Knee patient position Normal Good Fair Trace draping clinician position prime mover Extension Ankle patient position Normal Good Fair Trace draping clinician position prime mover Dorsi Flexion External rot.: Flexion Plantar Flexion Comments: 36 Ankle patient position Normal Good Fair Trace draping clinician position prime mover Inversion Eversion Comments: 37 Mercer County Community College Physical Therapist Assistant Program I, the undersigned, have received a copy of the course handbook for _______ __. My signature acknowledges that this information has been explained to me and that I have been given the opportunity to ask questions about the content of the handbook. I understand that I will be held accountable for the expectations of students within this course handbook and the PTA program handbook as stated or implied within them. My signature is provided voluntarily. There were a total of _____ pages. This signature page is page number _______. I have retained my copy of the other pages. I will keep this handbook as my guide throughout this semester. student name signature date Mercer County Community College Physical Therapist Assistant Program I, the undersigned, have received a copy of the course handbook for _______ __. My signature acknowledges that this information has been explained to me and that I have been given the opportunity to ask questions about the content of the handbook. I understand that I will be held accountable for the expectations of students within this course handbook and the PTA program handbook as stated or implied within them. My signature is provided voluntarily. There were a total of _____ pages. This signature page is page number ______. I have retained my copy of the other pages. I will keep this handbook as my guide throughout this semester. student name signature date 38 39 Mercer County Community College Physical Therapist Assistant Program Competency Testing Sign Off Sheet Student Name: Date Submitted: Semester: Fall Spring Summer Year: 04 05 06 07 08 Comments Course/Competency Test: tester/date: Attempt #: 1 2 3 Course/Competency Test: tester/date: Attempt #: 1 2 3 Course/Competency Test: tester/date: Attempt #: 1 2 3 Course/Competency Test: tester/date: Attempt #: 1 2 3 Course/Competency Test: tester/date: Attempt #: 1 2 3 Course/Competency Test: tester/date: Attempt #: 1 2 3 Course/Competency Test: tester/date: Attempt #: 1 2 3 Course/Competency Test: tester/date: Attempt #: 1 2 3 Course/Competency Test: tester/date: Attempt #: 1 2 3 40 41