Site: College of Rehabilitation Sciences Department of Physical Therapy NEUROMUSCULOSKELETAL CLINICAL SKILLS CHECKLIST

Transcription

1 Name: Site: College of Rehabilitation Sciences Department of Physical Therapy NEUROMUSCULOSKELETAL CLINICAL SKILLS CHECKLIST ASSESSMENT PROCESS / TECHNIQUE Opportunity to review and integrate A. Information gathering - chart review i. Relevant admission history ii. Social history iii. History of present illness/complaints iv. Past medical history v. Physician orders (relevant to PT) vi. Current medications vii. Relevant prior Physiotherapy intervention viii. Reports on investigative procedures: interpretation Imaging Radiography Other B. Information gathering relevant history taking Observed Performed Becoming Confident confident i. Entrance complaints or primary problem ii. History of present illness/complaints a. Location of primary complaints b. Symptomatic issues related to pain/discomfort c. Exacerbating and abating factors d. Description of pain/complaints iii. Social history iv. Past medical history a. Relevant prior trauma or surgery b. Awareness of past or current medical condition that may impact recovery or exercise prescription v. Knowledge about given health condition (pathology and clinical manifestations of given health condition) vi. Determine physiotherapy diagnosis from subjective examination vii. Determine clients level of irritability to help clinically reason which objective tests to perform for the objective examination viii. 3 rd party information as patient unable to provide Page 1 of 7

2 C. Information Gathering physical examination Observed Performed Becoming Confident confident i.observation / Inspection General appearance: posture and position tests of all spinal and peripheral joints o Understand the causes of common postural changes o Understand the consequence of common postural change Integument system: Skin condition, colour, scars/incision, muscle atrophy/hypertrophy, Respiratory system: Pattern of respiration including respiratory rate, accessory muscle use if present, synchronous or asynchronous.. Expansion of thorax during respiration ii. Active range of motion (AROM) Observation of AROM for all spinal and peripheral joints AROM measurement with a tape measure for decreased spinal ROM AROM measurement of all peripheral joints using various sized goniometers Appreciation of typical trick movements for all areas of assessment iii.passive range of motion (PROM) Performs PROM for all spinal and peripheral joints knowing the normal and pathologic end feels Performs PPM s and PIVM s Performs PAM s and PAVM s Identifies capsular and non-capsular patterns of restriction for peripheral and spinal joints Interpret patterns of inert tissue lesions iv.muscle tests Resisted isometric testing- selective tissue tension testing to determine if the contractile unit is problematic Interpret patterns of contractile unit lesions Performs length testing on various spinal and peripheral muscles Performs manual muscle testing when indicated on various spinal and peripheral muscles Page 2 of 7

3 v. Biomechanical exam Performs osteokinematic and arthrokinematic assessments on peripheral and spinal joints i. Position tests ii. Performs PPM s and PIVM s iii. Performs PAM s and PAVM s vi. Functional status AROM bed mobility and repositioning gait / ambulatory status need for gait aid prescription gait aid sizing and prescription muscular strength / endurance vii. Measurement of HR, BP, RR, at rest and with exercise viii. Identify impairments ix. Palpation Appropriate and accurate palpation of relevant soft tissue and boney anatomy Other INTERVENTIONS Observed Performed Becoming Confident confident A. Health Education (list below the types of health education opportunities you have observed or performed) Page 3 of 7

4 B. Treatment techniques i. Stretching exercises ii. Strengthening exercises Strengthening exercise for spinal and peripheral muscles with the cause of the weakness in mind when prescribing exercises iii. Soft tissue massage Transverse friction massage Trigger point compression Various strokes iv. Mobilizations v. PROM PPM, graded mobilizations for spinal and peripheral joints vi. AROM AAROM vii. Electro-physical agents Mechanical traction Ultrasound Interferential therapy current TENS viii. Education Nature of problems Activity modification Posture correction C. Techniques to improve mobility Bed mobility and transfer training Gait re-education D. Techniques to improve aerobic capacity and strength aerobic exercise prescription resistance/circuit exercise prescription E. Inter-professional collaboration Describe PT role function Team functioning Collaborative leadership Inter-professional conflict resolution Inter-professional communication Patient / Client / Family / Community centered care Page 4 of 7

5 Please the key indicator conditions i encountered during any of the clinical placements. Categories Key Indicator Conditions Cervical Spine Increased lordosis Whiplash Disc injury Lower motor neuron impairment Chronic neck pain Z joint sprain Shoulder AC joint separation GH joint dislocation Ligament sprains Rotator cuff strain Contusions SLAP lesions Impingement Nerve compression Adhesive capsulitis Rotator cuff repair GH stabilization Elbow Elbow joint dislocation Muscle strain Contusions Ligament sprains Epicondylitis Nerve compression Page 5 of 7

6 (specify) Wrist/Hand Sprains Nerve compression Nerve compression (CTS) Tendonosis Tendon repairs Lumbar spine/pelvis Increased lordosis Radiculopathy Disc injury Lower motor neuron impairment Chronic low back pain pain SI joint dysfunction Z joint sprain Hip Sprains Contusions Chronic hip pain Groin pull Nerve entrapment Hip replacement Page 6 of 7

7 Knee Meniscal lesions Ligament sprains Patellar dislocation PFS Tendonosis ITB friction syndrome Ligament repair Meniscal repair ORIF Ankle Sprains Plantar fasciitis Metatarsalgia ORIF i Entry-to-Practice Physiotherapy Curriculum: Content Guidelines for Canadian University Programs Council of Canadian Physiotherapy University Programs, May 2009 Page 7 of 7