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73 Cards in this Set
- Front
- Back
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Functional Assessment
Purpose ? |
Focuses a patient’s evaluation on functional activities not on a medical diagnosis. The functional assessment uses tests and measures which will yield a patients baseline function, prognosis, criteria for placement in work or rehab settings, levels of safety and effectiveness of interventions.
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Performance Based Assessments
who observes? examples? |
Therapist observes an activity under a certain set of criterion.
Examples: Six Minute Walk Test, Sitting Test. Functional Reach Test, Jump Test, Stair Stepping… |
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Performance Based Assessments
Self-Assessments main idea |
The patient answers a set of questions which inquire as to the patient’s ability to perform certain activities.
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Standard Terminology
Independent Supervision Close guarding |
-Consistent performance safely
-Assistance w/in arm’s reach - Assistance is ready to assist not touching |
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Standard Terminology
Contact guarding Minimum assistance Moderate assistance Maximum assistance |
-Hands on guarding
-Completes majority w/o assistance -Completes part of w/o assistance -Unable to complete w/o assistance |
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Standard Terminology
Normal Good Fair |
- Steady Balance w/o support inc. dynamic
- Static steady balance w/o support -Static balance w/hand hold |
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Standard Terminology
Poor None |
-Handhold assistance required for static
-Unable to hold position, motion etc. |
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Barthel Index
what kind of test? how many dimensions? how many items on test? |
Performance based test
Uni-dimensional functional assessment 10 items on test |
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Barthel Index
what does it measure? how is the global score calculated? reliable inter and intra-reliabilty? |
Measures a person’s independence with each mobility or self care activity.
Global score is calculated from 0-100 As a functional test, the Barthel Index is considered to have a high degree of inter and intra-rater reliability. |
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Katz Index
what is it based on? how many dimensions? how many categories? |
-Performance based test
-Uni-dimensional functional assessment -6 categories of testing |
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Katz Index
what are its sources? how is its reliability? how are scores given? |
-Uses both direct observation and patient/family reporting over a 2 week period
-Inter-rater and Intra-rater reliability is good. -Scores are given and them set at a grade of A-G |
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Katz Index of ADL Grading Scale
A B C D |
A: Independent in feeding, continence, transferring, toileting, dressing and bathing
B: Independent in all but one of these functions C: Independent in all but bathing and one additional function D: Independent in all but bathing dressing and one additional function |
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Katz Index of ADL Grading Scale
E F G Other |
E: Independent in all but bathing dressing going to toilet and one additional function
F: Independent in all but bathing dressing going to toilet transferring and one additional function G: Dependent in all six functions Other: Dependent in at least two functions but not classifiable as C, D, E or F |
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Functional Independence Measures (FIM)
how many dimensions? how many items and what are the areas? All items are also part of what? |
- Multi-dimensional tool
-18 item measure of physical, psychological and social function -All items are part of the Uniform Data System for Medical Rehabilitation |
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Functional Independence Measures (FIM)
What are the levels used to assess? Reliability? |
- FIM levels are used to place patients and receive funding for medical rehabilitation units/hospitals
- Strong inter/intra- rater reliability once instructed on the instrument |
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Special Test for the Spine
Distraction Test |
Nerve Root compression at foramen.
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Special Test for the Spine
Compression Test |
Facet joint
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Special Test for the Spine
Valsalva Test |
Herniated Disc
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Special Test for the Spine
Swallowing Test |
Bony protuberances or Soft Tissue swelling
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Special Test for the Spine
Adson Test |
Tight Scalenes
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Special Tests of the Shoulder
Yergson Test |
Bicipital Stability
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Special Tests of the Shoulder
Drop Arm Test |
Tears in the Rotator Cuff
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Special Tests of the Shoulder
Apprehension Test |
Chronic Shoulder Dislocation
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Yergason Test
Purpose? Possible Cause? |
-Determines bicep stability in the bicipital groove
-Ligament tear |
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Yergason Test
Position Motion |
Position: Sitting shoulder neutral elbow flexed at 90
Motion/Resistance: Pull into ER and elbow extension. |
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Yergason Test
Documentation |
(+) Bicep tendon will pop out of groove w/pain
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Drop Arm Test
Purpose Possible Cause |
Purpose: Detects tears in the rotator cuff.
Possible Cause: Tear in the supraspinatus |
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Drop Arm Test
Position Motion |
Position: Sitting shoulder neutral elbow extended
Motion/Resistance: Ask the patient to raise the arm in abduction and then slowly lower arm. |
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Drop Arm Test
Documentation |
(+) If arm drops or cannot lower slowly w/o pain
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Apprehension Test
Purpose Possible Cause |
Purpose: Determines chronic tendency towards shoulder dislocation.
Possible Cause: Anterior shoulder instability. |
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Apprehension Test
Position Motion |
Position: Sitting/Standing/Supine shoulder neutral elbow flexed at 90.
Motion/Resistance: Pull arm into abduction and ER. |
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Apprehension Test
Documentation |
(+) If patient does not allow movement, looks scared or shoulder actually subluxes/dislocates.
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Tinel Sign
Purpose Possible Cause |
Purpose: To assess the integrity of the ulnar nerve.
Possible Cause: Nerve inflammation due to compression within the ulnar groove or neuroma |
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Tinel Sign
Position Method |
Position: Sitting or Supine with elbow flexed slightly.
Method: PTA taps the ulnar nerve at ulnar groove |
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Tinel Sign
Documentation |
(+) Tingling sensation w/distribution into forearm and hand.
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Test for Lateral Epicondylitis (Tennis Elbow)
Purpose Possible Cause |
Purpose: Detects lateral epicondyle inflammation
Possible Cause: Increased stress at elbow. |
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Test for Lateral Epicondylitis (Tennis Elbow)
Position Motion |
Position: Sitting or Supine with elbow flexed slightly and forearm pronated.
Method: PTA resists wrist flexion and finger extension |
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Test for Lateral Epicondylitis (Tennis Elbow)
Documentation |
(+) Pain at epicondyle. If pain is felt above the lateral epicondyle, extensor carpi radialis longus is indicated. If pain is felt at the epicondyle, then extensor carpi radialis brevis is indicated.
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Test for Medial Epicondylitis (Golfer’s Elbow)
Purpose Possible Cause |
Purpose: Detects wrist flexor inflammation
Possible Cause: Increased stress or overuse of wrist flexors. |
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Test for Medial Epicondylitis (Golfer’s Elbow)
Position Motion |
Position: Sitting or Supine with elbow flexed slightly and forearm supinated.
Method: PTA extends wrist through full range of motion and full elbow extension |
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Test for Medial Epicondylitis (Golfer’s Elbow)
Documentation |
(+) Pain at epicondyle
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Allen’s Test
Purpose Possible Cause |
Purpose: Tests integrity of radial and ulnar arteries supplying the hand.
Possible Cause: Compression of the arteries due to overuse or swelling (pathological) |
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Allen’s Test
Position Method |
Position: Sitting or Supine with elbow flexed slightly and wrist fully flexed.
Method:Pt. actively flexes/extends the wrist several times, stopping with fist clenched. PTA palpates arteries and then asks the patient to open the fist. |
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Allen’s Test
Documentation |
(+) No flushing of blood to the digits is apparent.
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Finkelstein’s Test
Purpose Possible Cause |
Purpose: Detects inflammation at the thumb extensors, de Quervain’s disease, or trigger thumb.
Possible Cause: Increased stress or overuse of extensor pollicis brevis and abductor pollicis longus. |
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Finkelstein’s Test
Position Method |
Position: Sitting or Supine and subjects makes a fist with the thumb curled into the grip.
Method: PTA moves the wrist into ulnar deviation. |
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Finkelstein’s Test
Documentation |
(+) Pain at wrist laterally.
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Faber’s Test Or Patrick’s Test
Indication Method Result |
Indication: SI dysfunction or impairment.
Method: Subject is supine. The test limb is place on the shin of the opposite limb. The test foot slides up the opposing shin into flexion, abduction and ER. The PT may then passively push the test limb to the table. Result: (+) with pain in the hip or back during any of the test movements. |
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Piriformis Test
Indication Method Result |
Indication: Tight piriformis causing sciatic nerve compression or pain in the back, hip down the back of the leg.
Method: Sidelying with the test limb on top and in hip flexion and knee flexion. The PTA pushes the knee into adduction. Result: (+) pain during adduction of the hip. |
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Trendelenburg Sign
Indication Method Result |
Indication: Weakness of the gluteus medius during unilateral weight bearing (gait).
Method: Standing on one leg. Result: (+) the pelvis is not maintained in a level position. |
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Special Tests for the Knee
Patellofemoral Tests 3 |
Clarke’s Sign
McConnell’s Test Monkey walk |
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Special Tests for the Knee
Meniscal Tests 3 |
McMurray’s Test
Apley’s Grinding Test Bounce Home Test |
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Special Tests for the Knee
Ligamentous Tests 6 |
Apley’s Distraction Test
Valgus Stress Varus Stress Anterior Drawer Posterior Drawer Lachman’s Test |
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Clarke’s Sign or Patellofemoral Grind Test
Indication Method Result |
Indication: Patellofemoral dysfunction
Method: Supine with the PTA holding the patella superiorly. The patient is then asked to perform a quad set. Result: (+) pain with contraction or not able to hold the contraction. |
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McConnell’s Test
Indication Method Result |
Indication: Patellofemoral dysfunction
Method: The patient is asked to perform any exercise that increased patellofemoral pain symptoms. Then, the PTA holds the patella medially and asks the patient to repeat the painful activity. Result: (+) pain is diminished when moved medially. |
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Monkey Walk
Indication Method Result |
Indication: Patellofemoral dysfunction (sometimes associated with Osgood Slaughter disease or patellar tendonitis)
Method: The patient is asked to crouch in full knee flexion and walk in the position. Result: (+) pain at the knee or tibial tuberosity with the activity. |
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McMurray’s Test
Indication Method Result |
Indication: Meniscal tear
Method: Supine with the patients knee brought into full flexion. While the examiner holds the test heel and applies either medial tibial rotation or lateral rotation, the subjects knee is extended. Result: (+) pain/snapping/clicking during movement. Valgus/Lat. Rotation – Medial Meniscus, Varus/Medial Rotation – Lateral Meniscus. |
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Apley’s Grind Test
Indication Method Result |
Indication: Meniscal Tear
Method: Prone with knee flexed to 90. Compressive force is placed through the heel to the knee and into lateral rotation or medial rotation. Result: (+) Pain in lateral rotation = lateral meniscus, pain in medial rotation = medial meniscus. |
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Bounce Home Test
Indication Method Result |
Indication: Meniscal dysfunction
Method: Supine with the knee in full flexion. The examiner passively extends the knee. Result: (+) Extension is not complete and might have a springy end feel. |
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Apley’s Distraction Test
Indication Method |
Indication: Medial or lateral collateral injury
Method: Prone w/knee flexed at 90. The knee is distracted and then placed in lateral and medial rotation. |
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Apley’s Distraction Test
Result |
Result: (+) Pain with any movement.
w/lateral rotation and medial pain = medial collateral w/medal rotation and lateral pain = lateral collateral |
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Valgus Stress
Indication Method Result |
Indication: Medial Collateral ligament dysfunction
Method: Supine and 20 – 30 degrees of knee flexion. PTA places a Valgus stress on knee. Result: (+) pain or gapping during the procedure. |
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Varus Stress
Indication Method Result |
Indication: Lateral collateral ligament dysfunction
Method: Supine w/ the knee placed at 20-30 flexion. PTA places a varus stress on the knee. Result: (+) pain or gapping with test. |
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Lachman’s Test
Indication Method Result |
Indication: Anterior cruciate dysfunction
Method: Supine w/hip in slight ER and knee in 20-30 degrees knee flexion. PTA distracts the joint and performs an anterior shift. Result: (+) Lack of a firm end feel. |
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Anterior Drawer Test
Indication Method Result |
Indication: Anterior Cruciate Dysfunction
Method: Supine with knee flexed at 90. PTA pulls knee into an anterior position at the tibia. Result: (+) Greater than 6 mm translation of tibia on femur. |
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Posterior Drawer Test
Indication Method Result |
Indication: Posterior Cruciate Dysfunction
Method: Supine w/knee at 90 degrees flexion. PTA places a posterior shift on the tibia. Result: (+) The posterior translation is not equal to the uninvolved side or is excessive. |
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Special Tests for the Ankle/Foot
4 main tests |
Drawer Test
Varus Test Valgus Test Homan’s Sign |
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Drawer Test
Indication Method Result |
Indication: Ankle instability caused by ligamentous sprain.
Method: Sitting or supine w/ ankle in 20 degrees of plantar flexion. PTA stabilizes distal leg and displaces the calcaneus forward on the talus. Result: (+) Excessive displacement foreward or unilateral indicates a sprain. |
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Varus Test
Indication Method Result |
Indication: Anterior/Posterior talofibular and Calcaneofibular sprain
Method: Sitting or supine, PTA stabilizes distal leg and rocks the calcaneus into inversion. Result: (+) Excessive movement or gapping in inversion. |
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Valgus Test
Indication Method Result |
Indication: Deltoid ligament sprain
Method: Sitting or supine w/ PTA stabilizing distal leg. The calcaneus is rocked into eversion. Result: (+) Excessive movement or gapping into eversion. |
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Homen’s Sign
Idication Method Result |
Indication: DVT
Method: Supine, prone or sitting. PTA passively extends the knee and then dorsiflexes the ankle. Result: (+) Pain in calf during dorsiflexion. |
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Special Tests for Elbow/Wrist/Hand
5 tests |
Tinel Sign
Tennis Elbow Test Golfer’s Elbow Test Allen’s Test Finkelstein’s Test |
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Special Tests for the Hip
3 tests |
Faber’s Test
Piriformis Test Trendelenburg Sign |
