Kinesiology 2711 Qualitative Skills Analysis Clinical Considerations
Clinical Assessment Qualitative vs. Quantitative Assessment • Observed quality of function vs. measured quantity of function.
Clinical Assessment Subjective vs. Objective Assessment • What patient describes vs. what clinician observes
The Clinical Setting Goal: To use all knowledge and skill necessary to accurately assess and diagnose the condition of our patients, to enable the facilitation of optimal health through all available means.
Chiropractic Subluxation • The alteration of the normal dynamic, anatomic, or physiologic relationships of contiguous articular structures. • An aberrant relationship between two adjacent articular structures that may have functional or pathologic sequelae, causing an alteration in the biomechanical and/or neurophysiologic reflections of these articular structure, and/or body systems that maybe directly or indirectly affected by them.
… In other words • A biomechanical articular lesion that can affect normal joint movement, neurology, anatomy and physiology. • Profound effect on quality of life.
Objective Assessment Includes: • Gait and postural analysis • Functional tests • Articular mobility/alignment tests • Muscle Function Tests • Neurological Tests
Qualitative Analysis in Chiropractic • Alignment and symmetry of vertebral units • Intersegmental joint mobility • Orthopedic Tests • Posture analysis • Gait and movement analysis
Human Structure and Function • The human body is structured to be bilaterally symmetrical • Nearly every person presents with some degree of asymmetry • How much is too much? • What is clinically relevant?
Leg Length Inequality • Either Functional or Structural • 5mm significant for low back pain • 10mm predisposed to DJD
Functional Mobility • Human body can be described as a system of moveable links (Motion Segment). • Diminished mobility in one motion segment will tend to upset the equilibrium of the rest of the movement system. • Will eventually lead to hypomobility/ hypermobility syndrome, muscle irritation and spasm, inflammation and pain.
Gillet’s Model • Considers the process of mechanical jont dysfunction to develop through three different phases of joint fixation. • Muscular • Ligamentous • Articular
Deterministic Model • Can be used in assessment to incorporate all factors that result in optimal function. • Also in treatment interventions to ensure therapy will more likely affect desired outcome.
Sacroiliac Joint Function Alignment Joint Mobility Muscular Status Active ROM Passive ROM Trigger Points Functional Leg L. Neurological Inhibition Anatomic Leg L. Inflammation Firing Patterns
Clinical Outcomes • Biomechanics is an important aspect of every variety of musculoskeletal condition. • Careful assessment and appropriate treatment interventions are necessary to resolve these types of conditions. • Maintenance care may be warranted as these dysfunctions tend to reoccur.