Musculoskeletal Orthopaedic Assessment: Difference between revisions
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* At each step of examination use a verbal command to let patient what is to be done. <ref name=":2" /> | * At each step of examination use a verbal command to let patient what is to be done. <ref name=":2" /> | ||
== Checklist for Musculoskeletal assessment == | |||
#Gather supplies: Documentation, assessment tools. <ref name=":3" /> | |||
#Take measures for proper hygiene during examination.<ref name=":3" /> | |||
#Be organized and systemic. <ref name=":3" /> | |||
== Sequence of examination == | == Sequence of examination == | ||
# | # Detailed History<ref name=":4">Musculoskeletal Key. [https://musculoskeletalkey.com/musculoskeletal-assessment/ Musculoskeletal assessment]. PHYSICAL MEDICINE & REHABILITATION; 2016. Available from: <nowiki>https://musculoskeletalkey.com/musculoskeletal-assessment/</nowiki></ref> | ||
# | # General observation of the patient: Arms, legs, gait, ability to sit and stand, posture, balance . <ref name=":3" /><ref name=":4" /> | ||
# Lying down Position<ref name=": | # Examination of movements (ROM- Range of Motion), muscle strength and muscle tone. <ref name=":2" /><ref name=":3" /><ref name=":4" /> a. Standing Position: Sagittal plane, frontal plane (coronal), transverse plane. b. Sitting Position: Sagittal plane, frontal plane (coronal), transverse plane. c. Lying down Position: Sagittal plane, frontal plane (coronal), transverse plane. | ||
# Palpate bones, joints, muscles, and surrounding tissue. <ref name=":3" /> | |||
== | # Performance of special test. <ref name=":2" /><ref name=":4" /> | ||
# Tests and outcome measure. | |||
# Document the assessment. <ref name=":3" /> | |||
# | |||
# | |||
== Aims of subjective assessment == | == Aims of subjective assessment == |
Revision as of 03:57, 19 January 2022
This article is currently under review and may not be up to date. Please come back soon to see the finished work! (19/01/2022)
Original Editor - Niha Mulla
Top Contributors - Niha Mulla, Oyemi Sillo, Naomi O'Reilly and Kim Jackson
Introduction[edit | edit source]
Complex clinical reasoning decisions in real time and becoming competent in patient assessment takes practice, refinement and reflection. Patient assessment is an essential skill for every student and practicing physiotherapist.[1]
A complete musculoskeletal examination of the patients gives an over view of patients body structure and function. Musculoskeletal/orthopaedic patient assessment is a process of appropriate subjective assessment with the understanding of particular joints , with use of specific tests at those particular joints and also appropriate subjective and objective markers along with understanding the need for continuous reassessment. [1][2]
Human body is bi-laterally symmetrical. Hence during a musculoskeletal assessment each body part is compared not only to an ideal normal but also to symmetrical other side of the body in a sequential manner in order to determine abnormalities in alignment of bone/joint/muscle to other. [2][3]
Basic principles[edit | edit source]
- Upon qualifying, physiotherapist are legally responsible for performing accurate assessment and management skills.
- Physiotherapist are suppose to access the patient on first contact for their initial assessment to determine patients problem and establish line of treatment for the patient.[1]
- Reassessment of patient is mandatory in- between treatment sessions to be aware and alert of any improvement or deterioration in patient condition. [1]
- Always re-access your patient using subjective and objective markers following each treatment to judge the efficacy of each intervention to determine in short term and long term effects.[1][3]
Patient preparation[edit | edit source]
- Introduce yourself and explain your role to the patient.[4]
- Confirm patient ID using a valid identifier for name and age.. Also ensure patients privacy and dignity.[4]
- Explain the process to the patient and let them know they can ask any questions they have.
- Let the patient know they will be observed, inspected/palpated for assessment.[3][4]
- Patient should be in comfortable, loose clothing. It is a good idea to provide a clean and hygienic gown. [3][4]
- It is advisable to have an assistant/patients caregiver in the examination room at all time.
- At each step of examination use a verbal command to let patient what is to be done. [3]
Checklist for Musculoskeletal assessment[edit | edit source]
- Gather supplies: Documentation, assessment tools. [4]
- Take measures for proper hygiene during examination.[4]
- Be organized and systemic. [4]
Sequence of examination[edit | edit source]
- Detailed History[5]
- General observation of the patient: Arms, legs, gait, ability to sit and stand, posture, balance . [4][5]
- Examination of movements (ROM- Range of Motion), muscle strength and muscle tone. [3][4][5] a. Standing Position: Sagittal plane, frontal plane (coronal), transverse plane. b. Sitting Position: Sagittal plane, frontal plane (coronal), transverse plane. c. Lying down Position: Sagittal plane, frontal plane (coronal), transverse plane.
- Palpate bones, joints, muscles, and surrounding tissue. [4]
- Performance of special test. [3][5]
- Tests and outcome measure.
- Document the assessment. [4]
Aims of subjective assessment[edit | edit source]
- bulleted list
- x
Aims of objective assessment[edit | edit source]
- bulleted list
- x
Subjective assessment[edit | edit source]
Objective assessment[edit | edit source]
Spinal assessment[edit | edit source]
Lumbar spine[edit | edit source]
Cervical spine[edit | edit source]
Peripheral joint assessment[edit | edit source]
Shoulder joint[edit | edit source]
Hip joint[edit | edit source]
Knee joint[edit | edit source]
Ankle and foot[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 Stuart Porter, Lynne Gaskell at al. Tidy’s Physiotherapy, Chapter 2 “Musculoskeletal Assessment". 2003 Edition 13
- ↑ 2.0 2.1 HATHAWAY L. Pump up your musculoskeletal assessment. Nursing made incredibly easy. 2004 May 1;2(3):46-50.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Thompson J, Walton A. The Musculoskeletal Screening Examination booklet. University of Western Ontario. Available from: https://rheum.ca/wp-content/uploads/2017/11/The_Musculoskeletal_Screening_Examination_Booklet.pdf
- ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 Clarkson HM. Musculoskeletal assessment. Wolters Kluwer Health/Lippincott Williams & Wilkins,; 2013.
- ↑ 5.0 5.1 5.2 5.3 Musculoskeletal Key. Musculoskeletal assessment. PHYSICAL MEDICINE & REHABILITATION; 2016. Available from: https://musculoskeletalkey.com/musculoskeletal-assessment/