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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

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Injury Assessment & Evaluation

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  1. Injury Assessment & Evaluation

  2. Today’s topics... • Principles of range of motion testing, neurological testing, and special tests • Functional testing

  3. Range of Motion Assessment • Categories & progression 1. AROM 2. PROM 3. RROM

  4. AROM • Voluntary movement through muscle contraction • Establishes willingness and ability to move • Helps determine damage to contractile tissue

  5. AROM • Assess all movements of joint • Check for bilateral equality • Assess fluidity & extent of movement • Palpate joint throughout movement

  6. 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”

  7. 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

  8. 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

  9. Movement terminology Flexion/extension

  10. Movement terminology ABDuction/ADDuction

  11. Movement terminology • Internal/external rotation • Aka medial/lateral

  12. Movement terminology Plantar flexion/dorsiflexion Inversion/eversion Radial/ulnar deviation

  13. Movement terminology Horizontal ABDuction/ADDuction Lateral flexion L/R rotation

  14. Manual muscle testing

  15. Neurological testing • Evaluate • Sensation • Motor function • Deep tendon reflexes • Identify • Nerve root impingement • Peripheral nerve damage • CNS trauma • Disease

  16. Neurological testing • Indicated by • Numbness • Paresthesia • Muscular weakness • Pain of unexplained origin • Injury to cervical or lumbar spine

  17. Neurological testing • Spinal nerve roots & segmental nerves • Roots supply area of skin & series of muscles 1. Dermatome 2. Myotome

  18. 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

  19. 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

  20. 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

  21. Ligamentous Stress tests

  22. 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 (-)

  23. Special tests

  24. Functional Testing • Tests of motor coordination, proprioception, & sport specific skill • Tests are sport specific--> performed during sport participation

  25. Next... • Legal concerns

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