40 Questions
What is the primary purpose of gathering information necessary to devise a safe treatment plan?
To identify possible red flags and underlying pathology
What is the primary purpose of establishing goals of treatment?
To facilitate treatment with direction and intent
What is the primary purpose of using 'SOAP' notes?
To facilitate problem-solving
Why is it necessary to identify impairments during the assessment process?
To establish goals of treatment
What is the primary purpose of using objective data in the 'SOAP' notes?
To provide an objective means to monitor results of treatment
Why is it necessary to use a standardized method of recording assessments?
To facilitate communication with other healthcare professionals
Why is it necessary to maintain accurate and comprehensive assessment records?
To comply with regulatory standards
What is the primary purpose of the 'Assessment' component in the 'SOAP' notes?
To facilitate informed clinical decision making
What should be included in a treatment plan?
Treatment goals, techniques, structures treated, and frequency of treatment
What is the primary purpose of taking a case history?
To gather information about the patient's complaint
Why should the unaffected side be tested first?
To compare the affected side to the unaffected side
Why should painful tests be performed last?
To avoid skewing the results of the assessment
What should the therapist do if the patient experiences pain during a test?
Stop the test and identify the location and nature of the pain
What is the purpose of lesion site palpation?
To identify the source of the problem
What should the therapist observe during the assessment process?
Bilaterally, including the unaffected side
What is the sequence of an assessment protocol?
Case history, observation, palpation, functional tests, rule outs
What is the primary purpose of using overpressure in a clinical assessment?
To clarify the end feel or end range
What is the term for a joint being susceptible to ligamentous sprain, tendonitis, early arthritis, dislocations, and subluxations?
Hypermobility
What type of end feel is characterized by a 'mushy feel'?
Tissue Approximation
What is the term for the quality of motion or sensation that a clinician feels in the joint during overpressure at the end of passive range of motion?
End Feel
What is the purpose of asking the patient about their pain during a clinical assessment?
To understand the location and nature of the patient's pain
What type of condition is suggested by hypomobility?
Muscle strains, nerve compression syndromes, and cartilaginous damage
What is the term for when bone touches another bone during a movement?
Bone to Bone
Who is credited with defining six end feels?
Cyriax
What is the primary goal of palpation in clinical assessment?
To identify specific objects of palpation
What is the focus of the therapist's attention during palpation?
The objects of palpation
What is the primary consideration when selecting the contact surface of the hand?
The object being palpated
What is the purpose of using both hands simultaneously during palpation?
To compare left and right sides of the body
What is the characteristic of scanning or stroking palpation?
It is used to collect information from a large area
What is the purpose of static palpation?
To palpate movement phenomenon
What is the result of regular practice of palpation?
Development of intelligent touch
What is the consideration when applying force during palpation?
The task at hand
What can be assessed in the superficial fascia?
Fluid pressure and skin mobility
What is a characteristic of the deep layer of fascia?
It requires more refined palpation skills
How can muscle tension be assessed?
By noting the response to compressive and shearing forces
What is the anatomical barrier?
The final resistance to normal range of motion
What is the result of elevated resting tone?
Increased muscle tension
What is the characteristic of the periosteum?
It is a thin, dense, spongy layer
What occurs when there is soft tissue dysfunction?
Restrictive barriers
What is the range of motion with the least amount of resistance?
Midrange
Study Notes
Clinical Assessment and Treatment Planning
- Gathering information necessary to devise a safe and effective treatment plan involves:
- Identifying possible red flags (serious underlying pathology) and previous injuries that may contraindicate certain techniques
- Noting medications and underlying health conditions that may impact treatment
- The goal of a treatment plan is to:
- Identify patient goals and establish goals of treatment
- Facilitate treatment with direction and intent
- Ensure that treatment addresses the cause of the complaint to yield effective results
SOAP Notes
- SOAP is an acronym for Subjective data, Objective data, Assessment, and Plan
- SOAP notes are a common assessment recording method used by healthcare professionals to:
- Organize assessment data
- Easily understand and refer to in the future
- A treatment plan in SOAP notes includes:
- Treatment goals or aims
- Techniques used to achieve those goals
- Structures on which techniques are applied and duration/frequency of treatment
- Number and frequency of future treatments and when to re-examine
Assessment Protocol
- The assessment sequence typically follows:
- Case history
- Observation
- Palpation
- Rule outs
- Functional tests (ROM tests AF, PR, AR)
- Special tests
- Muscle tests
- Neurological tests
- Joint play examination
- Lesion site palpation
- General guidelines for clinical assessment include:
- Testing bilaterally and comparing results
- Testing the unaffected side first to establish a baseline
- Performing painful tests last to avoid skewing results
- Noting and stopping if the patient experiences pain during a test
Palpation
- Palpation involves feeling and interpreting the characteristics of tissues
- Objects of palpation include specific structures or areas of focus
- Contact surfaces for palpation include hands, fingers, thumbs, and palms
- Force of palpation varies according to the task and includes rate, pressure, direction, and duration
- Types of palpation include:
- Scanning/stroking over a large area (quick and collecting information)
- Static palpation (no movement, used for palpating movement phenomena)
Tissue Mobility and Restrictive Barriers
- Normal soft tissue range of motion includes:
- Physiological barrier (range of motion available in normal circumstances)
- Elastic barrier (range of motion at the end of passive range)
- Anatomical barrier (final resistance to normal range, beyond which further motion causes injury)
- Restrictive barriers occur when there is soft tissue dysfunction (skin, fascia, muscle)
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