Clinical reasoning - LL injuries Flashcards
How to pick tests - physical exam
- what did you observe in functional tests
- what deficits can be associated
- what impairments can contribute to development of this
How do you assess impairment
- quality e.g. ROM, mvt
- quantify e.g. distance, degrees
- maximal ability
- pain-free ability
What are some of the overall concepts you can test
- joint mobility
- muscle function
- balance/proprioception
- biomechanics/mvt control
- ADL/sport performance
how can you assess joint mobility
- AROM
- PROM
- AROM w overpressure
- accessory glides
- clearing adjacent joints
What are the different types of ROM deficits
Lack
Lag
What is lack ROM deficit
- decreased PROM and AROM (=)
- due to articular block, decreased glides, decreased soft tissue length
What is lag ROM deficit
- full PROM, lacks AROM
- can be due to muscle weakness/insufficiency
How do you assess muscle function
- MMT
- dynamometry
- RM strength testing
- isometric hold
- reps until failure
- vert jump
- muscle length tests
- mvt quality
What are the possible causes of muscle dysfunction
- lack of strength/endurance/power
- inability due to pain
How do we assess balance an proprioception
Duration
Distance
Quality
- Y-balance test
- JPS
- SL stance tasks
- hopping
What is the BESS test
Balance Error Scoring System
- 6 balance tasks for 20 sec each
- count number of errors (10max)
Aims of SL hop test
dynamic tasks to test quality of balance in hopping
looking for…
- using other limb for support
- trunk motion
- needing hands to correct balance
- bracing other limb against stance
How do we assess mvt control
- observation > looking for deficits
- rating quality
can challenge them through load and balance
Example of mvt control tests
Lying hip abduction test
Sl squat
How do we assess ADL squat or sport performance
- walking/run distance
- timed stair climb
- agility tests
- sprint speed
- acceleration
- stopping/deceleration
looking for pain-free ability, maximal effort, quality
