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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 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