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IN THE NAME OF GOD

IN THE NAME OF GOD. FARAJI.Z.MD. ADDITIONAL SPECIAL TEST. The special tests performed at this phase should be used to further differentiate between pathological and normal tissue suspect to be pathological based on the findings. several types of special tests. . Joint stability tests

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IN THE NAME OF GOD

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  1. IN THE NAME OF GOD FARAJI.Z.MD

  2. ADDITIONAL SPECIAL TEST • The special tests performed at this phase should be used to further differentiate between pathological and normal tissue • suspect to be pathological based on the findings

  3. several types of special tests • . Joint stability tests integrity of the inert joint tissues, specifically the joint capsule and ligaments (ex:ant drawer test) • Joint compression test inert joint tissues that line the joint surface, such as the articular cartilage and meniscus (McMurray’s) • anthropometric assessments (general body structure/ body composition assessment)

  4. Neurological testing • unexplained loss of strength, paresthesia, or numbness, or has sustained an injury to the vertebral region • sensory (dermatomes) • motor (myotomes), • reflex (deep tendon, superficial, and pathological reflexes)

  5. spinal nerve roots and peripheral nerves • Other • cranial nerve assessment, • neuropsychological assessment (cognitive ability • cerebellar function (coordinated movements: finger to nose)

  6. Dermatome testing. • innervated by a specific nerve root • bilateral comparison • sharp and dull discrimination, hot and cold discrimination, and two-point discrimination to assess peripheral nerve injury

  7. Dermatome testing.

  8. Myotome testing.

  9. Reflex testing. • deep tendon reflexes, • superficial reflexes, • pathological reflexes

  10. deep tendon reflexes

  11. Superficial reflexes • Upper abdominal • Lower abdominal • cremasteric, • plantar, • gluteal. • Anal reflexes

  12. Pathological reflexes • Upper motor neuron • Lower motor neuron

  13. Neurological test finding • nerve root compression, • nerve root stretch, • motor neuron lesion

  14. Functional SCREENING tests • Part of the preparticipation physical examination • Trainer observe movement

  15. Overhead and single leg squat tests

  16. Landing error scoring system

  17. Tuck jump test

  18. Functional movement screen bridge the gap between preparticipation exams and performance testing /fundamental movement • Deep squat • Hurdle step • In-line lunge • Shoulder mobility test • Active straight-leg raise • Trunk stability pushup • Rotary stability test

  19. SOAP Notes • S(Subjective) • 0 (Objective) • A (Assessment) • P (Plan)

  20. Setting Rehabilitation Goals • Rehabilitation goals should be included as part of the treatment plan in the SOAP note • The rehabilitation goals should be based upon the information gathered during the evaluation and should address signs and symptoms recorded in the SOAP note

  21. Short-Term Goals • Decrease swelling by 30 percent within 4 days • Increase active range of motion by 50 percent within 1 week • Progress to full weight bearing during walking gait within 1 week • Reduce acute pain by 50 percent within 4 days • Increase eversion ankle strength by 50 percent in 4 days • Increase plantar flexion ankle strength by 50 percent in 4 days

  22. Long-Term Goals • Return to limited practice using protective tape support within 2 weeks • Return to full practice using protective tape support within 2.5 weeks • Return to full competition using protective taping within 3 weeks

  23. Progress Evaluations • The progress evaluation should be based on the athletic trainer's knowledge of exactly what is occurring in the healing process at any given time • To ensure that the progress evaluation will be complete. it is still necessary to go through certain aspects of history, observation, palpation, and special testing

  24. History • How is the pain today, compared to yesterday? • Is the patient able to move better and with less pain? • Does the patient feel that the treatment done yesterday helped or made him sorer?

  25. Observation • How is the swelling today? More or less than yesterday? • Is the patient able to move better today? • Is the patient still guarding and protecting the injury? • How is the patient's attitude—upbeat and optimistic, or depressed and negative?

  26. Palpation • Does the swelling have a different consistency today, and has the swelling pattern changed? • Is the injured structure still as tender to touch? • Is there any deformity present today that was not as obvious yesterday?

  27. Special Tests • Does ligamentous stress testing cause as much pain, or has assessment of the grade of instability changed? • How does a manual muscle test compare with yesterday? • Has either active or passive range of motion changed? • Does accessory movement appear to be limited? • Can the patient perform a specific functional test better today than yesterday?

  28. Progress Notes • SOAP format • in the form of an expanded treatment note, or may be done as a weekly summary • types of treatment • short-term goals • the course of treatment over the next several days

  29. THANKS FOR YOUR ATTENTION

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