Basic Measurement (Week 1) - Istanbul Gelisim University PDF

Name of Department : Physical Therapy and Rehabilitation Course Code and Name : Basic Measurement And Assessment In Physiotherapy Course Week : 1.Week Course Day and Time : Monday 09:00 – 12:50 Course Credit/ACTS Information : 3/4 Ex...

Name of Department : Physical Therapy and Rehabilitation Course Code and Name : Basic Measurement And Assessment In Physiotherapy Course Week : 1.Week Course Day and Time : Monday 09:00 – 12:50 Course Credit/ACTS Information : 3/4 Examination Type and Gradings : Instructor’s Name & Surname : Busenur KARAGÖZ E-mail & Phone: : [email protected] Instructor’s Room : Office Hours : GBS Link : | 14 WEEKS’S COURSE CONTENTS | Instructor’s Room : Office Hours : GBS Link : | 14 WEEKS’S COURSE CONTENTS | 1.Week Patient History and Basic Principles of 9.Week Normal Joint Movement Assessment Movement 10.Week Normal Joint Movement Assessment 2.Week Anatomical Axis and Planes 11.Week : Muscle Strength Assessment and Manual 3.Week Posture Analysis; Anterior and Lateral Muscle Testing; Trunk Muscles Posture Analysis Loading… 4.Week Posture Analysis; Posterior Posture Analysis 12.Week Manual Muscle Testing; Lower Extremity Muscles 5.Week Shortness Tests and Flexibility 13.Week Manual Muscle Testing; Cervical Region and Upper Extremity Muscles 6.Week Anthropometric Measurements; Circumference and Length Measurements 14.Week Manual Muscle Testing; Facial Muscles 7.Week Anthropometric Measurements; Diameter Nervous System and Musculoskeletal System and Fat Tissue Measurements 15.Week General Review MIDTERM EXAM FINAL EXAM | WEEKLY LEARNING OUTCOMES |  MIDTERM EXAM FINAL EXAM | WEEKLY LEARNING OUTCOMES | o Takes patient history o Evaluates patient objectively and subjectively o Applies basic assessments in the field of Physiotherapy and Rehabilitation. | DAILY FLOW |  | DAILY FLOW | 09.00-09.50/ Patient History Loading… 10.00-10.50/ Patient History and Subjective Assesment 11.00-11.50/ Patient History and Subjective Assesment 12.00-12.50/ Objective Assesment | PATIENT HISTORY AND EVALUATION |  | PATIENT HISTORY AND EVALUATION | The patient's history begins with the observation of the patient's appearance, such as expression, posture, and gait, as soon as the patient enters the room. The history should be obtained by interviewing the patient. If the patient has an emotional illness, communication or behavioral disorder, the necessary information should be obtained from relatives.  | PATIENT HISTORY AND EVALUATION | Before meeting with the patient, the patient's file must be reviewed and regular notes must be kept. The date of each test and treatment change must be recorded regularly. Home programs given to the patient must also be recorded in the file  | | PATIENT HISTORY AND EVALUATION General principles in history taking; Main complaint or others History of the disease (symptoms) Patient's functional history Curriculum Vitae (CV) - family history Review of body systems Social history Occupational history Psychological and psychiatric history Risk factors for cardiovascular disease Medications taken  | PATIENT HISTORY AND EVALUATION | 1) Main Complaint And Others The main problem that the patient is seeking help for is this.The aim is to learn this complaint as expressed by the patient. The form of the complaint plays an important role in shaping the symptoms and determining the disease. When determining the main complaint, it is also necessary to look at whether there is a loss of function. If there is a loss of function, the factor that causes this in the patient's complaint must be determined.  | PATIENT HISTORY AND EVALUATION | 2) History of the Disease (Symptoms) While the patient is telling the situation he/she is in, the history of the disease is also taken. By listening to the patients carefully, findings such as loss of sensation and weakness are taken verbally from the patient, and then specific questions about the symptoms are asked. The patient should be allowed to tell his/her entire story. In the analysis of the symptoms, the onset, character, severity, localization, relationship with time and whether it is combined with other complaints are examined. If received, previous treatments and their results should also be recorded.  | PATIENT HISTORY AND EVALUATION | 3)Functional History Evaluation of the disease in terms of rehabilitation often reveals loss of function. In the functional history, the remaining capacity after the disease should be evaluated. Loading… Not only the patient's current functional status but also the functional level before the disease should be known. Whether or not the person can perform daily living activities and the person's level of independence should be determined.  | PATIENT HISTORY AND EVALUATION | 4)Curriculum Vitae – Family History The patient's health throughout his/her life, functional abilities, and history of operations. Family history is also important in terms of congenital problems and heart diseases.  | PATIENT HISTORY AND EVALUATION | 5)Review of Body Systems Cardiovascular, pulmonary, neurological, musculoskeletal systems should be reviewed both from the patient file and the patient's history. The status of body functions is important in treatment and education.  | PATIENT HISTORY AND EVALUATION | 6)Social History It should be learned who the patient lives with and where, where he/she will go during or after treatment, whether the house he/she lives in is suitable for the disease, and the effectiveness of the family in providing home care. Standard home life, diet, smoking, alcohol, and drug addiction should be noted. The patient's communication level is important, if there is a difference between the interests received from the patient and the physical assessment findings, these should be covered with correct communication.  | PATIENT HISTORY AND EVALUATION | 7)Work History: It is important to learn the patient's level of education, his/her job and where he/she works, his/her special skills and hobbies outside of work. It is also important to be able to cover the cost of treatment. 8)Psychological and Psychiatric History: Social and psychological status before and during the illness, and his/her perspective on life and illness are important.  | | PATIENT HISTORY AND EVALUATION 9)Cardiovascular and Disease-Related Risk Factors Risk factors that may cause the disease to progress should be investigated. 10)Medications Taken The medications used by the patient and their daily doses should be recorded. After the history is taken, a physical assessment should be performed.  | EVALUATION | Evaluation of the patient helps both to strengthen the diagnosis and to help determine the treatment program. The evaluation should include; S: Subjective Assessment (History and Observation) O: Objective Assessment (Tests) A: Analysis (Analysis of Information Obtained) P: Plan (Planning of Treatment Program) | EVALUATION |  | EVALUATION | Objective Assessment Neurological assessment Musculoskeletal, soft tissue and Mental status joint assessment Motor system Cardiac and pulmonary system Sensory system assessment Reflexes Skin Vision, hearing, swallowing and speech Pain ability Functional assessment Walking and ambulation ADL assessment | NEUROLOGICAL ASSESMENT |  | NEUROLOGICAL ASSESMENT | Mental Status: In the evaluation, the patient's place, time, person orientation, memory, concentration, calculation ability, behavior, level of consciousness criteria are taken into account. If the patient's condition remains serious, the Glasgow coma scale is used. There are 3 basic evaluations in this scale 1-Eye opening 2-Verbal responses 3-Motor system response  | NEUROLOGICAL ASSESMENT | Motor System: Tenderness with palpation, stiffness, spontaneous motor activity, tremor, decreased or increased tone and nodules. ROM, muscle strength, shortness, flexibility, endurance. o Sensory system The localization of the disease is determined with sensory testing. Pain, hot, cold, vibration, position sense, two-point discrimination, sense of touch, o Anesthesia: complete loss of all senses o Hypoesthesia: reduction of senses o Paresthesia: pins and needles, tingling sensation o Dysesthesia: pain sensation, especially with stimulation o Hyperesthesia: excessive sensitivity  | NEUROLOGICAL ASSESMENT | Reflexes: Deep tendon reflexes, superficial reflexes and pathological reflexes are evaluated. For example, deep tendon reflexes are hyperactive in upper motor neuron lesions, and decreased or lost in lower motor neuron lesions.  | NEUROLOGICAL ASSESMENT | Deep tendon reflex: The simplest response we can obtain without expecting a mental or psychic response from the organism is the reflexes that operate at the spinal level. The most well-known of these is the contraction that occurs in a muscle when a tendon is hit. In the upper extremities: There are biceps, triceps, styloradial reflexes. In the lower extremities: There are patellar and Achilles reflexes.  | NEUROLOGICAL ASSESMENT | Vision, hearing, swallowing, speech: Aphasia, Dysphasia, Aphonia, Dysphonia, Dysarthria are evaluated. Walking and ambulation: Evaluated by observation or gait analysis. If the patient uses any assistive devices, these should be used for evaluation.  | NEUROLOGICAL ASSESMENT | Aphasia: The impairment of language and speech and the inability to understand as a result of damage to the brain. Dysphasia: Patients have difficulty finding words and names. Aphonia: Loss of voice. The cause is usually a disease or injury to the nerves that control the speech muscles. Dysphonia: Voice disorders involving the larynx are called dysphonia. It is a voice quality disorder. Dysarthria: The command from the brain is correct, but there is a problem with the organs that help speech due to the incorrect formation of the joint.  | NEUROLOGICAL ASSESMENT | Musculoskeletal System, Soft Tissue and Joint Assessment The observation begins with the patient entering and the right and left sides of the body are examined symmetrically. If there is asymmetry, it should be recorded. Posture, atrophy, edema, scar tissue, skin changes should be observed. Muscles, joints, and bones should be palpated. Spasms, edema, and tenderness should be recorded. Joint limitations should be evaluated with goniometric measurements. Observation- Passive and Muscle Strength Joint Stability Palpation Active Range of Test Motion  | NEUROLOGICAL ASSESMENT | Cardiac and Pulmonary System Evaluation Exercise Tests Lung Function Tests Chest Circumference Measurements Skin: Should be examined for trophic disorders.  | NEUROLOGICAL ASSESMENT | Pain Assesment: Various scales are used in pain assessment. These are Visual Analog Scale (VAS) McGill Pain Quastionaire  | NEUROLOGICAL ASSESMENT | Functional Assessment - Evaluation of Daily Living Activities Determining the level of independence: Eating Hair care Make-up Dental care, Bed-bath-toilet transfers, Dressing, Vehicle use, Wheelchair use  | WHAT TO TAKE HOME? | o The patient's history begins as soon as the patient enters the room. o The form of the complaint plays an important role in shaping the symptoms and determining the disease. o The evaluation should include; SOAP (Subjective Objective Analysis Plan) o When taking the history, not only the patient's current functional status but also their pre- Loading… illness functional level should be known. o Glasgow coma scale has 3 basic evaluations; Eye opening, verbal responses, motor system response o Anesthesia: complete loss of all senses o Hypoesthesia: reduction of senses o Paresthesia: pins and needles, tingling sensation o Dysesthesia: pain sensation, especially with stimulation o Hyperesthesia: excessive sensitivity | QUESTIONS AND SUGGESTIONS | o Dysesthesia: pain sensation, especially with stimulation o Hyperesthesia: excessive sensitivity | QUESTIONS AND SUGGESTIONS | The evaluation does not include which of the following: Subjective Assessment Plan Analysis Objective Assessment Treatment | QUESTIONS AND SUGGESTIONS |  | QUESTIONS AND SUGGESTIONS | Which of the following words is used to describe the tingling? Anesthesia Hypoesthesia Paresthesia Dysesthesia Hyperesthesia | RECOMMENDED WEEKLY STUDIES |  | RECOMMENDED WEEKLY STUDIES | 3 days a week, 1 hour each will be enough | REFERENCES |  | REFERENCES | Tedavi Hareketlerinde Temel Değerlendirme Prensipleri, Prof.Dr Saadet OTMAN, Prof.Dr Nezire KÖSE, 2016 | ABOUT THE NEXT WEEK | | ABOUT THE NEXT WEEK | All movements are defined according to the ‘Anatomical position’ in the standing position, head forward, upper extremities at the sides, thumbs and fingers extended, palms facing forward and feet held together. There are three specific planes and axes passing through the body and they are perpendicular to each other. The point where they all intersect is 1-2 cm in front of the sacral 2nd vertebra, which is the body’s center of gravity.  ………….. – ………………………… Since course presentations are private, using the texts and images contained herein on social media or else without permission from the course instructor is against the regulations Law No. 6698.  “To see me does not necessarily mean to see my face. To understand my thoughts is to have seen me.”