Scenario 1: Patient arrives with a known neurologic diagnosis (Stroke, Multiple Sclerosis, Neuropathy, etc.)Īpproach: Use your knowledge about the patient’s injury or condition and the impairments and activity/participation limitations commonly associated with that injury/condition to select your tests/measures. If you don’t work in inpatient rehab and you don’t happen to work in a setting that allows for much longer 1:1 sessions with the therapist then you need to be selective and judicious when structuring your exams.
If you are lucky enough to work in a magical PT clinic where you can spend 2 hours evaluating your patient on the first day then by all means, have at it. If you aren’t as comfortable with the myriad of neurologic screening tools out there and haven’t worked with that population of patients for a long time or very often, use the information below as a jumping off point for selecting tests that should help you recognize how the neurologic and neuromuscular systems are impacted in your patients.
As clinicians gain experience they often draw very heavily on their understanding of injury and disease and their past patient experiences to make hypotheses that allow them to immediately narrow down the tests and measures they believe will be most pertinent.
As a student physical therapist or novice clinician, the clinical reasoning process often involves administering a lot of subjective and objective outcome measures, looking at the results for anything that suggests an impairment or functional limitation then deriving a PT diagnosis and plan of care based on the results of those tests. Performing a good neuro screen requires both an understanding of the purpose of each neurologic test and measure and an ability to determine when to use what test. You can find that in your neuro rehab textbook. **Alright, quick forewarning here that this is not a completely comprehensive outline of every possible neurologic test you can perform on your patient. Also, so it doesn’t seem as though I’m just picking on the ortho therapists out there, Neuro Folks, if you aren’t screening your patients for and addressing their orthopedic problems, you’re missing an important piece also! Nothing to be ashamed of, we can’t be experts in everything, but having a basic comfort with the elements of the neuro screen will go a long way in helping therapists create a more comprehensive and effective plan of care and also help identify patients that need to be referred back to their doctors for more testing or medical care. Unlike a neurologic examination/evaluation that many of us perform on a patient with a known neurologic condition, I consider the neurologic screen to be a tool that helps inform therapists whether the nervous system may be involved in a patient that does not have a known neurologic condition, to help differentially diagnose an impairment that may be undiagnosed or unrecognized or to provide valuable information about nervous system function that could impact the plan of care.ĭespite our comprehensive education in physical therapy school, I bet all practicing therapists have been faced with the reality that unless you use a particular area of knowledge or skill pretty regularly, you lose your familiarity and comfort with it pretty quickly. If you haven’t ever encountered this, there is a good chance you missed out on an important opportunity to screen for neurologic impairments in at least some of your patients. Even if you decided well before you graduated PT school that you would never work with neurologic patients and you were going to dedicate your career to sports and orthopedic rehab you will undoubtedly encounter scenarios in which you need to do at least some elements of the neurologic screen. If you work in pediatric therapy, OP neuro rehab, acute care or inpatient rehabilitation settings you will most likely find yourself needing to do elements of a neuro screen during your evaluations.
#Instructions for zyliss fastcut herb mincer professional#
Use with caution and consult a medical professional familiar with your case beforehand. *Disclaimer: the information on this site is intended as general information only and does not serve as personal medical or therapeutic advice.
0 kommentar(er)
