Stroke: Physiotherapy Assessment

Original Editor - Naomi O'Reilly Top Contributors - Naomi O'Reilly, Kim Jackson, Simisola Ajeyalemi, Vidya Acharya, WikiSysop, Adam Vallely Farrell, Rucha Gadgil and Amrita Patro  

Introduction

According to Ryerson (2008) assessment in neurological physiotherapy is a process of collecting information about disordered movement patterns, underlying impairments, activity restrictions, and societal participation for the purpose of intervention planning. While Bernhardt & Hill (2005) outline that the purpose of assessment is to help the therapist determine the best intervention. Assessment is arguably the most important step in the rehabilitation process, as our clinical reasoning is based on th einformation it provides and provides the basis for our decision making throughout the rehabilitation process. Johnson & Thompson (1996) outlined that treatment can only be as good as the assessment on which it was based. So in order for us to progress and manage our treatment plan and ensure we are identifying out patients problems assessment should be an ongoing and continuous, and should allow us toindividualised, patient-centred goals and ultimately a tailor-made treatment plan for the individual.

Database

History of Present Condition

• Date of Onset of Signs & Symptoms
• Progression of the Condition
• Medical Management
• Medical Observations
• Other Management
• Previous Therapy
• Results of Specific Investigations
  Blood Tests
  X-Rays
  CT Scans
  MRI Scans
  

Past Medical History 

• Co-morbidities and other non-related conditions
• Special Equipment, Technology Dependency
• Previous Surgery
• Medication History

Subjective

The subjective assessment is used to provide a detailed picture of how the present condition affects the patient. 

Social History

• Social Situation
• Family Support
• Accommodation
• Social Service Support

Activity

• Normal Daily Routine
• Employment
• Leisure Activities

Mobility

• General
• Indoor
• Outdoor
• Steps & Stairs
• Falls

Personal Care

• Washing
• Continence
• Dressing

Other

• Vision
• Hearing
• Swallowing
• Fatigue
• Pain
• Perceptions of own Problems/Main Concern
• Expectations of Treatment

Objective

Posture and Balance

• Alignment
• Neglect
• Sitting Balance
• Standing Balance
  

Voluntary Movement

• Range of Movement
• Strength
• Endurance
• Coordination 
  Finger to Nose Test
  Heel to Shin Test
  Rapidly Alternating Movement

Involuntary Movement

• Tremor
• Clonus
• Chorea
• Associated Reactions

Tone

• Decreased
  Flaccid
• Increased
  Spasticity
  Rigidity (Cogwheel or Lead Pipe)

Reflexes

• Deep Tendon Reflexes
  Biceps (C5/6)
  Triceps (C7/8)
  Knee (L3/4)
  Ankle (S1/2)
• Plantar Reflex (Babinski’s Sign)
• Hofmanns Reflex

Sensory

• Light Touch
• Pin Prick
• Two Point Discrimination
• Vibration Sense
• Proprioception
• Temperature
• Vision and Hearing

Functional Activities

• Bed Mobility
• Sitting Balance
• Transfers
• Upper Limb Function
• Mobility
• Stairs

Gait

• Pattern
• Distance
• Velocity
• Use of Walking Aids
• Orthotics
• Assistance
• Cognitive Status
• Attention
• Orientation
• Memory
  

Summary

Recent Related Research (from Pubmed)

References

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