Inspection is an art of data collection. Subjective data is obtained by listening to the patient's complaints. Sometimes, there are complaints or concerns that the patient does not say/hid
. The practitioner should be aware of this possibility
and try to obtain an accurate history. The most common reason for applying to a physical therapy doctor is pain and joint movement limitation.
Musculoskeletal system screening examination looks at gait, posture and symmetry
or asymmetry. This is normally done in a standing position
. Experienced physicians usually pose questions and the examination
is performed to find answers to these problems. The patient is examined in different positions, including standing, supine, and prone. The patient should be naked and relaxed
.
Posture analysis should be done. Asymmetrical posture changes may be indicative of segmental
dysfunction. The patient should be seen as a whole
and the general mobility level of the whole body should be observed. When the painful area is examined naked, a color change due to vasomotor events can be observed on the skin.
Tissue structural abnormality is palpable evidence of physiological dysfunction.
Right and left and above and below should be compared with palpation.
If we evaluate without comparison, it would be difficult to reach a meaningful conclusion.
Palpation is performed in layers. Changes in skin temperature and humidity,
sensitivity, tension, subcutaneous adhesion, local sensitivity, change in consistency
(hardness/softness) can be detected.
Redness, If there is swelling, pain-sensitivity and warmth, this indicates that there is an acute change in tissue
structure and therefore acute inflammation
. In acute structural changes of the tissue, sweating
is increased and the skin is usually moist. In chronic abnormalities in tissue structure, the skin is thin, dry, atrophic and cold. The palpable structure is firm or fibrotic.
There are characteristic palpation features that may also be due to disorders
.
Positional
changes can be found with spinal palpation outside the soft tissue. It may happen. Bone asymmetries and loss of movement can be detected. Sometimes, as opposed to loss of movement, segments may be hypermobile
. Situations where the bones are very mobile are situations in which manual therapy
should not be performed. The sensitivity areas of the spinal protrusions that arise with pressure and during movement are also important.
The decrease in vertebral springing (loss of joint
mobility) and sensitivity caused by pressure should be noted.
Active movement should be visually inspected. Active movement is performed by placing fingers on the facet area
to palpate
.
The most important method in the diagnosis of functional joint disorders is joint
motion mobility. It is a jug. For the joint instability test, the joint surfaces are shifted parallel to each other in a way that does not cause any change in ROM (range of motion).
This shifting process is performed by the physician without applying great force and without causing pain. /p>
It should be possible without waking up. Restriction indicates pathology. If movement is regained by repeating the EO test
improvement in limited ROM
may be observed. Although ROM is limited and painful, EO is generally painless. For this reason
for this reason, EO
can be used in cases where passive ROM is contraindicated for therapeutic purposes.
It is important to evaluate isometric muscle contraction during the examination. Because
The pain occurring during isometric contraction is often not of mechanical-functional joint origin
and therefore does not respond well to manual therapy.
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