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Systematic Evaluation Process

Systematic Evaluation Process. Systematic Evaluation Process. What need to know for successful evaluation and impression? ANATOMY Pathomechanics Biomechanics of Sport Pathologies. Systematic Evaluation Process. Many different ways Must be Sequential Process Types of Evaluations

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Systematic Evaluation Process

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  1. Systematic Evaluation Process

  2. Systematic Evaluation Process • What need to know for successful evaluation and impression? • ANATOMY • Pathomechanics • Biomechanics of Sport • Pathologies

  3. Systematic Evaluation Process • Many different ways • Must be Sequential Process • Types of Evaluations • Clinical • On-field

  4. Systematic Evaluation Process • History • Most important part of evaluation • Communication skills • Simple Open-ended Questions • Mechanism • Sounds • Pain Location • Onset of Symptoms • Description of Symptoms • When • Joint Position • How • Previous Injury

  5. Systematic Evaluation Process Tips for taking a good history • LISTEN • Verbal vs Nonverbal Communication • Avoid slang and jargon language • Maintain eye contact • Be Calm and reassuring

  6. Systematic Evaluation Process • Inspection (Observation) • Really begins when patient enters athletic training room • Gait • Posture • Functional movement

  7. Systematic Evaluation Process • Inspection cont. • Deformities

  8. Systematic Evaluation Process • Inspection cont. • Deformities

  9. Systematic Evaluation Process • Inspection cont. • Deformities • Ecchymosis

  10. Systematic Evaluation Process • Inspection cont. • Deformities • Ecchymosis • Swelling • Effusion vs edema • Localized vs diffuse

  11. Systematic Evaluation Process • Inspection cont. • Deformities • Ecchymosis • Swelling • Effusion vs edema • Localized vs diffuse • Bilateral Symmetry

  12. Systematic Evaluation Process • Inspection cont. • Deformities • Ecchymosis • Swelling • Effusion vs edema • Localized vs diffuse • Bilateral Symmetry • Skin • Scars, ecchymosis, temp, color

  13. Systematic Evaluation Process • Palpation • Feeling for: • Point tenderness • Deformities • Crepitus • Gapping • Muscle tension/spasm • Temperature • Swelling (edema/effusion)

  14. Systematic Evaluation Process • Palpation Procedures • Injured vs non-injured side • Start away from injured part • Bony Tissue First

  15. Systematic Evaluation Process • Palpation Procedures • Injured vs non-injured side • Start away from injured part • Bony Tissue First • Ligament Structures Second

  16. Systematic Evaluation Process • Palpation Procedures • Injured vs non-injured side • Start away from injured part • Bony Tissue First • Ligament Structures Second • Muscle Tissue Third

  17. Systematic Evaluation Process • Range-of-Motion (ROM) • Active ROM (AROM) • Contraindications • Willingness to move

  18. Systematic Evaluation Process • Range-of-Motion (ROM) • Active ROM (AROM) • Contraindications • Willingness to move • Passive ROM (PROM) • Quantity of movement • Endfeels • Normal vs abnormal

  19. Endfeels (Normal vs Abnormal)

  20. Systematic Evaluation Process • Range-of-Motion (ROM) • Active ROM (AROM) • Contraindications • Willingness to move • Passive ROM (PROM) • Quantity of movement • Endfeels • Normal vs abnormal • Resistive ROM (RROM) • Break test vs manual muscle test • Grading System

  21. Grading Scale for RROM

  22. Systematic Evaluation Process • Ligament and Capsular Tests • Structural integrity of non-contractile tissue • Bilateral comparison

  23. Systematic Evaluation Process • Special Tests • Bilateral comparison • Specific to a structure, joint or body part

  24. Systematic Evaluation Process • Neurological Tests • Sensory • Dermatome • Myotome • Reflex Testing

  25. Systematic Evaluation Process • Neurological Tests • Sensory • Dermatome • Myotome • Reflex Testing

  26. Systematic Evaluation Process • Neurological Tests • Sensory • Dermatome • Myotome • Reflex Testing

  27. Systematic Evaluation Process • Functional Tests • Coordinated movements specific to sport or position

  28. On-field Evaluation

  29. On-field Evaluation Must rule out • Cardiovascular or respiratory failure • Life-threatening head or spinal injury • Profuse bleeding • Fractures • Joint dislocation • Peripheral nerve injury • Other

  30. On-field Evaluation -- History • Clear Communication • Briefer than Clinical • Mechanism • Pain location • Noises • Signs and symptoms

  31. On-field Evaluation --- Inspection • When does this begin? • Is the athlete moving? • Position of Athlete? • Conscious or unconscious? • Observe as soon as walk on the field

  32. On-field Evaluation --- Palpation • Bone alignment • Crepitus • Joint alignment • Swelling • Pain • Deficits in muscle or tendons

  33. On-field evaluation – ROM Testing • AROM, PROM, RROM • Contraindications

  34. On-field evaluation --- Ligamentous and Special Tests • Usually single plane tests • Gives immediate impression

  35. On-field evaluation --- Neurological Tests • Very important if suspect head or spine injury • Also with fractures and dislocation

  36. Removal of Athlete from Field • DECISIONS, DECISIONS. WHAT SHOULD YOU DO? • Fractures, dislocations, gross joint instability, spinal injury • Ways to remove athlete once make the decision

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