Chapter 10 Assessment (pages 107-128)

Question 1

What do you do as a RMT if the client has been treated or diagnosed before by another health care professional before coming to see you?

Answer 1

Even if the client has been diagnosed previously you must always achieve your own understanding of the clients condition.
This relates to a safe, effective treatment.

Question 2

What are some things that a assessment can provide for you about the clients condition?

Answer 2

What structures are involved,

Question 3

After concluding test on a client and considering if the client may have a certain condition how must you present this on the Health history form and to the client?

Answer 3

You must present this to the client in a way that does not raise alarm such as “The client presents with signs and symptoms consistent with…”.

Question 4

When doing Special Compression test on a clients C-spine what must you follow up with?

Answer 4

You have to follow these special test with a “Cervical Distraction”.
These are used to relive pressure on the clients vertebrae and it is a positive test as well if the clients pain is relived in the area.

Question 5

What should a basic treatment plan include for a client?

Answer 5

This will include things such as:
Duration of the treatment
positioning of the client
structures to be addressed
What techniques you will be using
 Post treatment self care

Question 6

What should be done if you don’t have a definitive answer for the testing done on the client or what should be done in the treatment plan?

Answer 6

Rather than just doing a general massage in the affected area:
You may also do supporting structures such as the hamstrings.
And assess the client with an open mind.
(It may also be appropriate to refer the client to another health care professional if the condition worsens or does not improve over time).

Question 7

How often should an RMT reassess the client?

Answer 7

The Therapist should reassess after each treatment and before the next one when the client comes back in.

The end of the treatment reassessment does not have to be a Total assessment but can include things like “reassessing the tight muscles you’ve worked on during the treatment”.

Question 8

What are the general types of health history questions you can ask a client?

Answer 8

These are called

Open Ended and Closed Ended questions.

Question 9

What is a Open ended question?

Answer 9

This is a question that does not limit the clients response.
For ex: What brings you in for a massage today?.

Question 10

What is a closed ended question?

Answer 10

This is a Yes or No question for the client.

Question 11

When is it most important for you to take the clients Bloop Pressure?

Answer 11

When you have the client for the first time so you have a good understanding of what Ci’s are present.
Current Bloop Pressure is very important.

Question 12

What are general things to observe in a client when you are assessing them?

Answer 12

Keep note of walking aids, facial expressions but it is also hard to know what the client is feeling so note it in a un biased way in the health history.

Question 13

What is Pastural and Gate Assessment for a client?

Answer 13

These are used to get a more specific assessment of the client.
Both of the assessments require the client wear a shorts or/and a T-shirt to provide the best analysis of the client.

(Both of these test require obtaining the clients consent to a postural assessment)

Question 14

What is a Pastural assessment of the client?

Answer 14

Analyses any imbalances the client may present and that may contribute to the clients condition.

Question 15

What is a gate assessment?

Answer 15

Analyses any imbalances the in how the client walks.

This can help revival what is causing the clients condition.

Question 16

What does a “Consent to a postural and gate assessment” require?

Answer 16

This involves a brief description of of why the assessment is necessary and what the client will have to wear for the assessment.

Question 17

What should be done when performing a “Pastural or Gate assessment”?

Answer 17

Take a general overview of the client first, If the injury on the client is temporary such as a sprain of the ankle then do a postural and gate after they have recovered as well to make sure they are not still using the compensatory positioning they have created.

Question 18

What should at least be done with a client even if a full Pastural assessment is not performed?

Answer 18

A general overview of the clients obvious asymmetries should be noted.

Question 19

What are the 4 T’s of Palpation?

Answer 19

Temp, texture, tenderness, tone.

Question 20

How do you effectively palpate?

Answer 20

You do it bilaterally starting with the none effected side of the client.

Question 21

What are things that you can do to make test of the client more accurate?

Answer 21

Instructing the client clearly, Self biomechanics is considered, do not perform muscle stretch testing to many times because it will loosen the tissue and give an improper test.

Question 22

How many Degrees in ROM is considered an improvement for the client?

Answer 22

An increase of 3-4 degrees is considered an improvement when worked on by one person.

Question 23

How can a RMT make testing safer?

Answer 23

Using slower movements to not tear tissues.

The test are performed up to but not beyond the the point of pain on a client.

Question 24

What can be used to measure ROM of a clients joints?

Answer 24

A Goniometer.
There are 2 types of Goniometers called:
Universal and an OB goniometer.

Question 25

How are test results recorded?

Answer 25

Both positive and negative test results must be recorded.

As well as the results that are within the normal limits.

Question 26

What are the types of test you can perform on a client?

Answer 26

There is (AF ROM) active free range of motion.
(PR ROM) Passive relaxed range of motion.
(AR) testing.
Special testing.

Question 27

How are test generally performed on a client?

Answer 27

You would do them Bilaterally, First on the Unaffected side then to the affected side of the client.

Question 28

What is End feel and Overpressure?

Answer 28

Overpressure is a term used when the therapist gradually applies more pressure when the end of the available passive range motion is reached.

The sensation transmitted to the therapist hands by the tissue resistance at the end of the available range is the end feel of the joint.

Question 29

What are the types of normal end feel?

Answer 29

Soft tissue approximation, Muscular or tissue stretch, Capsular stretch or leathery, bony.

Question 30

What are types of Abnormal end feel?

Answer 30

Empty, Muscle spasm, boggy or soft, Springy block or internal derangement, Capsular stretch or leathery, bony, A Capsular pattern, A non-capsular pattern.

Question 31

What is (AR) testing?

Answer 31

Active resisted testing is assessing the strength of the muscles.
Resistance to the clients muscles can be applied through gravity or by the RMT.

Question 32

What is (PR ROM) testing?

Answer 32

Passive relaxed range of motion is to test whether or not there is limitation or excess ROM and if there is it is noted.
This is done gently by the RMT to the client.

Question 33

What is (AF ROM) testing?

Answer 33

Active free rom is when the client goes through the joint movements themselves and whatever they are willing to do.
Any pain is noted by the client and RMT.

Question 34

What are forms of (AR) testing?

Answer 34

Isometric resistance and Isotonic resistance.

Question 35

What is a normal soft tissue Approximation end feel?

Answer 35

This is when the joint ROM is restricted by normal tissue bulk.
Feels like a soft compression.

Question 36

What is a normal Muscle or tissue stretch?

Answer 36

It has a feeling of increase tension and the client may feel a stretching sensation.

Question 37

What is a normal capsular stretch or leathery end feel?

Answer 37

occurs when the joint capsule is stretched at the end of its normal range. for the RMT it feels like stretching a piece of leather and for the client it is painless.

Question 38

What is a normal bony end feel?

Answer 38

This occurs when a bone contacts bone at the end of a normal ROM.
This feels like a abrupt and hard stop to the joint movement.

Question 39

What is an Abnormal Empty end feel?

Answer 39

This occurs when there is no physical restriction to the movement except the pain perceived by the client.

This indicates Acute bursitis or joint inflammation.

Question 40

What is Abnormal Muscle spasm end feel?

Answer 40

occurs when passive movement stops abruptly with Springy rebound and pain.
This is the result of reflexive muscle spasm used to prevent further injury.
It can indicate Synovial capsule inflammation.

Question 41

What is Abnormal boggy or soft end feel?

Answer 41

This occurs with joint effusion or edema.

It has a mushy or soft end feel and can indicate acute inflammation. In case of ligamentous injury…. check with britt.

Question 42

What is abnormal Springy block or internal Derangement end feel?

Answer 42

Indicates loose cartilage or meniscal tissue whiten the joint.

Question 43

What is abnormal Capsular stretch or leathery end feel?

Answer 43

Ask britt.

Question 44

What is abnormal Bony end feel?

Answer 44

This occurs before normal range indicates bony changes, such as Osteophytes present with degerniteve joint disease or following a fracture.

Question 45

What is abnormal Capsular pattern end feel?

Answer 45

Limited motion at an injured or affected joint.

Through the passive movement notes are taken if there is any thinkings or swelling.

Question 46

What is an abnormal non-capsular pattern?

Answer 46

It is limitation of movement of a joint but not in a capsular pattern.
Restriction may be due to an intra-articular blockage from torn pieces of cartilage.

Question 47

What is an abnormal non-capsular pattern?

Answer 47

It is limitation of movement of a joint but not in a capsular pattern.
Restriction may be due to an intra-articular blockage from torn pieces of cartilage.

Check book for more detail.