Objective Assessment Flashcards
How will the subjective assessment and SIN factor affect an objective assessment?
- High impact MOI?
- Positive red flag questions?
- High pain score (severity)?
- High irritability?
- Pain nature?
+ Nociceptive
+ Neurogenic (peripheral neurogenic)
+ Nociplastic (central sensitisation)
How does an objective assessment in MSK outpatients flow?
- Observation
- AROM
- Clearing joints
- PROM
- Muscle tests
- Palpation
- Special tests to area
- Functional testing
- Nerve/Neuro tests (neuro integrity, neuro sensitivity)
- Outcome measures
Why do we need to clear joints in an objective assessment?
To ensure the pain is coming from the joint/area we think it is (and not referred from another joint/area)
How do we clear joints in an objective assessment?
- Verbally check for other areas of pain (e.g.: common referral areas)
- AROM + PROM with over pressure of joint above + below
(Do NOT apply over pressure if AROM is restricted/painful or condition is highly irritable.)
What are special tests in an objective assessment?
Tests that can be helpful determining the absence or presence of a disease
Why do we use special tests in an objective assessment?
To add another piece to the ‘diagnostic jigsaw’
What are considerations required for special tests during an objective assessment?
- Validity
- Reliability
- Sensitivity
- Specificity
What are neurological tests?
Test the function or integrity of the peripheral nerves
What are functional tests?
Complex objective tests which replicate activities of daily living (e.g.: jump, squat)
Outcome measures.
- Can be subjective or objective
- Need to consider reliability and validity
- Give us a baseline
- Monitor progress
- Motivate patients
- Justify onwards referrals or discharge decisions
What does the ‘snOut’ rule mean for an objective test?
A negative ‘snOut’ rules it out
(sensitivity + they don’t have it)
What does the ‘spIn’ rule mean for an objective test?
A positive ‘spIn’ rules it in
(specificity + they do have it)
What can pins & needles/ numbness suggest about an injury?
Indicates nerve involvement
- Is it peripheral nerve irritation perhaps a neuroma after trauma or following surgical incision or spinal referred pain?
