Fundamentals of Tests and Measures for the Physical Therapist Assistant

Cover Page
Title Page
Copyright Page
Brief Contents
Contents
Preface
Features of This Text
Acknowledgements
About the Authors
Reviewers
Chapter 1 The Role of the Physical Therapist Assistant in the Physical Examination
	Introduction
	What is the Role of The Physical Therapist Assistant in The Physical Examination?
	The Aim of this Text
	Organization of This Text
		Part I. Communication
		Part II. Tests and Measures
	Clinical Reasoning
		Clinical Decision Making
			Use of Case Examples to Enhance Learning
		Self-Reflection
	Suggestions on Honing Data Collection Skills
	FINAL WORDS
	References
Part I Patient Communication & Subjective Data Collection
	Chapter 2 Cultivating a Therapeutic Partnership
		Introduction
		Fundamental Considerations of Patient/Clinician Interactions
			Communication Is the Key
				The Expressive Component: Talking with Patients
				The Receptive Component: The Importance of Listening
			Preparation of Setting and Self
				Preparing the Environment
				Preparing Your Physical Self
				Preparing Your Mental and Emotional Self
			Meeting Patients Where They Are
				Finding Your Inner Chameleon
				When the Need for Empathy Trumps the Clinician’s Agenda
			The Art of Digging Deep
			Biopsychosocial Aspects: Why No Two Patients Are Alike
			Culture
			Language Barriers
		Chapter Summary
		References
	Chapter 3 Treatment Considerations: Preparing for Treatment
		Introduction
		Preparing for Treatment
			Pre-Treatment Tasks
				Review Pertinent Information
				Medications
				Laboratory and Diagnostic Tests
				Information from Other Healthcare Providers
				Patient Observation
				Hand Hygiene
				Greeting the Patient
		The Art of Subjective Data Collection
			Effective Listening
			Types of Questions
			Interwoven Communication Tools to Enhance Patient Responses
				Prompters
				Clarification
				Reflection or Echoing
				Reflective Feeling
				Paraphrasing
				Summarizing
			The Importance of Nonverbal Language
			Motivational Interviewing Concepts
		Gathering Relevant Subjective Data
			Chief Complaint
			Associated Symptoms
			Current Level of Function
		Communicating Well While Documenting
		Chapter Summary
		References
	Chapter 4 Introduction to Physical Therapy Tests and Measures
		Introduction
		Which Tests and Measures Are Available?
		Choosing the Appropriate Tests and Measures
		Content and Organization of the Remaining Chapters
		References
Part II Tests and Measures: Building on the Foundation
	Chapter 5 Global Observation, Mental Functions, and Components of Mobility and Function
		Introduction
		Section 1: Global Observation
		Introduction
		Fundamental Concepts
		Priority or Pointless?
		Case Example
		Section 2: Mental Functions
		Introduction
		Communication Assessment
			Introduction
				Fundamental Concepts
				Procedure
		Priority or Pointless?
		Case Example
		Section 3: Cognition Assessment
		Introduction
		Fundamental Concepts
		Procedure
		Priority or Pointless?
		Case Example
		Section 4: Emotional and Psychological Factors
		Introduction
		Fundamental Concepts
		Procedure
		Priority or Pointless?
		Case Example
		Section 5: Posture
		Introduction
		Fundamental Concepts
		Procedure
			Informal Postural Assessment
		Anterior (A) and Posterior (P) Views
		Lateral View
		Priority or Pointless?
		Case Example
		Section 6: Mobility and Locomotion
		Introduction
		Fundamental Concepts
		Procedure
		Priority or Pointless?
		Case Example
		Section 7: Gait
		Introduction
		Fundamental Concepts
		Gait Characteristics and Quality
			Gait Cycle Terminology
				Descriptions of Common Pathological Gait Patterns
				The Importance of Gait Speed
		Procedure
		Priority or Pointless?
		Case Example
		Section 8: Functional Assessment
		Introduction
		Fundamental Concepts
		Procedure
		Priority or Pointless?
		Case Example
		Chapter Summary
		References
	Chapter 6 Cardiovascular and Pulmonary Examination
		Introduction
		Section 1: Core Vital Signs
		Introduction
		Pulse
		Fundamental Concepts
		Procedure
			Pulse Points
			Assessment of Pulse
		Respiration
		Fundamental Concepts
		Procedure
			Assessment of Respiration
		Blood Pressure
		Fundamental Concepts
			Equipment Used for Blood Pressure Measurement
		Procedure
			Assessment of Blood Pressure
		Priority or Pointless?
		Case Example
		Section 2: Temperature
		Introduction
		Fundamental Concepts
		Procedure
		Priority or Pointless?
		Case Example
		Section 3: Edema
		Introduction
		Fundamental Concepts
		Procedure
			Assessment of Pitting Edema
			Measurement of Edema
		Priority or Pointless?
		Case Example
		Section 4: Oxygen Saturation
		Introduction
		Fundamental Concepts
		Procedure
		Priority or Pointless?
		Case Example
		Section 5: Ankle-­Brachial Index
		Introduction
		Fundamental Concepts
		Procedure
		Priority or Pointless?
		Case Example
		Section 6: Other Common Cardiovascular and Pulmonary Tests and Measures
		Introduction
		Rating of Perceived Exertion
		Six-Minute Walk Test
		Chapter Summary
		References
	Chapter 7 Integumentary Examination
		Introduction
		Section 1: Examination of the Skin
		Introduction
		Fundamental Concepts
		Screening Inspection of the Skin
			Color
			Temperature
			Texture
			Moisture
			Turgor
			Edema and Effusion
		Malignancies of the Skin
		Screening Inspection of the Hair and Nails
			Hair
			Nails
		Signs of Inflammation and Infection
		Priority or Pointless?
		Case Example
		Section 2: Identification of Pressure Ulcers
		Introduction
		Fundamental Concepts
			Risk Factors for Pressure Ulcer Development
			Common Locations of Pressure Ulcers
		Procedures to Identify Potential and Active Pressure Ulcers
			Identification of Areas at Risk
			Classification of Pressure Ulcers
		Priority or Pointless?
		Case Example
		Section 3: Identification of Vascular Ulcers
		Introduction
		Fundamental Concepts
			Arterial Insufficiency
			Venous Insufficiency
		Procedures to Identify Vascular Insufficiency
			Assessment of Peripheral Pulses
			Venous Filling Time
			Capillary Refill Time
			Ankle-Brachial Index and Toe-Brachial Index
			Pitting Edema
		Priority or Pointless?
		Case Example
		Section 4: Identification of Neuropathic Ulcers
		Introduction
		Fundamental Concepts
			Diabetic Neuropathy
			Diabetes and Vascular Disease
		Procedures to Identify Neuropathy and Active Diabetic Ulcers
			Observation and Palpation
			Sensory Examination
			Peripheral Vascular Examination
			Describing and Classifying Diabetic Wounds
		Priority or Pointless?
		Case Example
		Section 5: Other Wounds and Burns
		Introduction
		Fundamental Concepts
			Skin Tears
			Surgical Wounds
			Burns
		Case Example
		Chapter Summary
		References
	Chapter 8 Musculoskeletal Examination
		Introduction
		Section 1: Range of Motion: Gross Screen
		Introduction
		Fundamental Concepts
			Active Range of Motion
			Limited Active Range of Motion
			Passive Range of Motion
			Joint End Feel
			Quantifying Gross AROM and PROM
			Documenting Estimated ROM
				Quantification Based on Estimated Numerical Range
				Quantification Based on Estimated Percentage of Range
				Quantification Based on Descriptors
		Procedure
		Priority or Pointless?
		Case Example
			Performing Passive ROM Screen
		Section 2: Range of Motion: Goniometry
		Introduction
		Fundamental Concepts
			Goniometric Devices
			Goniometric Techniques
			Functional Range of Motion
		Procedure
		Priority or Pointless?
		Case Example
		Section 3: Muscle Length
		Introduction
		Fundamental Concepts
		Procedure
		Priority or Pointless?
		Case Example
		Section 4: Gross Muscle Strength
		Introduction
		Fundamental Concepts
			Grading of Gross Strength
		Procedure
		Priority or Pointless?
		Case Example
		Section 5: Manual Muscle Testing
		Introduction
		Fundamental Concepts
		Procedure
			Grading Manual Muscle Testing
		Priority or Pointless?
		Case Example
		Section 6: Palpation
		Introduction
		Fundamental Concepts
		Procedure
		Priority or Pointless?
		Case Example
		Chapter Summary
		References
	Chapter 9 Neuromuscular Examination
		Introduction
		Section 1: Somatosensory Function
		Introduction
		Fundamental Concepts
		Procedure
			Light Touch
			Protective Sensation
			Pain (Sharp/Dull Test)
			Vibration
			Temperature
			Position Sense
				Joint Position Test
				Joint Space (Contralateral Mirroring) Test
				Finger-to-Nose Test
			Discriminative Sensation
				Stereognosis (defined as “object identification solely by touch”)
				Graphesthesia (defined as “the ability to identify writing on the skin solely by touch”)
				Two-Point Discrimination
				Point Localization
		Priority or Pointless?
		Case Example
		Section 2: Spinal Nerve Root Integrity
		Introduction
		Fundamental Concepts
			Dermatomes
			Myotomes
		Procedure
			Dermatomes
			Myotomes
		Priority or Pointless?
		Case Example
		Section 3: Deep Tendon Reflexes
		Introduction
		Fundamental Concepts
			Hypotonic DTRs
			Hypertonic DTRs
		Procedure
		Priority or Pointless?
		Case Example
		Section 4: Coordination
		Introduction
		Fundamental Concepts
		Procedure
			Upper Extremity Tests
				Rapid Alternating Movements (RAM)
				Finger Opposition
				Finger to Nose (or Chin)
				Finger to Clinician Finger
			Lower Extremity Tests
				Heel to Shin
				Toe to Clinician Finger
				Toe Tapping
				Tests of Standing or Walking
		Priority or Pointless?
		Case Example
		Section 5: Balance
		Introduction
		Fundamental Concepts
			Sensory System
			Sensorimotor Integration
			Motor Output
			The Role of Cognition
		Procedure
			Confidence in Balance
			Seated Balance
			Static Standing Balance Tests
				Romberg Test
				Single-Limb Stance Test
			Reactive Balance Tests
				Nudge/Push Test
			Anticipatory Balance Tests
				Functional Reach Test
				Catching
			Dynamic Balance Tests
		Priority or Pointless?
		Case Example
		Section 6: Cranial Nerve Assessment
		Introduction
		Fundamental Concepts
		Procedure
		Priority or Pointless?
		Case Example
		Section 7: Upper Motor Neuron Tests
		Introduction
		Fundamental Concepts
			Muscle Tone
				Hypotonia
				Hypertonia and Spasticity
		Procedure
			Testing for Spasticity
				Upper Extremity
				Lower Extremity
			Deep Tendon Reflexes
				Deep Tendon Reflex Assessment
			Clonus Testing
			Pronator Drift
			Pathological Superficial Reflexes
		Priority or Pointless?
		Case Example
		Chapter Summary
		References
Appendix A
Appendix B
Index