Download Injury Assessment & Evaluation

Injury Assessment
& Evaluation
Today’s topics...
 Principles of range of motion testing,
neurological testing, and special tests
 Functional testing
Range of Motion Assessment
 Categories & progression
1. AROM
2. PROM
3. RROM
AROM
 Voluntary movement through muscle
contraction
 Establishes willingness and ability to move
 Helps determine damage to contractile
tissue
AROM
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Assess all movements of joint
Check for bilateral equality
Assess fluidity & extent of movement
Palpate joint throughout movement
AROM
 Causes of limited movement
1. Pain*
5. Joint contractures
2. Swelling
6. Nerve damage
3. Muscle spasm 7. Loose bodies
4. Muscle tightness
*Where in the motion does it hurt?
“Painful arc”
PROM
 Movement of the part w/o assistance
from the injured individual
 Distinguishes injury to contractile tissues
from non-contractile tissues
 Position person lying down to relax
muscles
 Perform painful movements last
 Note end feel
RROM
 Assess muscle strength after injury
 Detect injury to nervous system
 Examples of results & implications:
1. Muscle weakness & pain--> strain
2. Muscle weakness &
pain -> nn damage
 Static & dynamic testing (pressure vs resistance)
 Grading system
Movement terminology
 Flexion/extension
Movement terminology
 ABDuction/ADDuction
Movement terminology
 Internal/external rotation
 Aka medial/lateral
Movement
terminology
 Plantar flexion/dorsiflexion
 Inversion/eversion
 Radial/ulnar deviation
Movement terminology
 Horizontal ABDuction/ADDuction
 Lateral flexion
 L/R rotation
Manual muscle testing
Neurological testing
 Evaluate
 Sensation
 Motor function
 Deep tendon reflexes
 Identify
 Nerve root impingement
 Peripheral nerve damage
 CNS trauma
 Disease
Neurological testing
 Indicated by
 Numbness
 Paresthesia
 Muscular weakness
 Pain of unexplained origin
 Injury to cervical or lumbar spine
Neurological testing
 Spinal nerve roots & segmental
nerves
 Roots supply area of skin &
series of muscles
1. Dermatome
2. Myotome
Neurological testing
 Assessment of dermatomes & myotomes
 Reflex testing
1. Changes -->degeneration OR injury
in specific regions of nervous system
2. DTR’s tend to be absent if specific
nerve root damage
Joint stability tests
 Assess integrity of ligamentous & capsular
tissues
 Tests apply tension to specific ligaments
 ALWAYS include tests for major ligament
damage & fxs in “On-field” evaluations
Laxity vs instability
 Laxity — clinical sign of the amount of
“give” within a joint; identified by stress
testing
 Instability — joint’s inability to function
under the stresses of function activity
Ligamentous Stress tests
Special tests
 Specific procedures applied to a joint to
determine presence of a particular
pathological condition
 Unique to each structure
 Results are compared
 Side to side
 Cause provocation
 Cause alleviation
 Reported as positive (+) or negative (-)
Special tests
Functional Testing
 Tests of motor coordination,
proprioception, & sport specific skill
 Tests are sport specific--> performed
during sport participation
Next...
 Legal concerns