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Assessment - Glossary Term Illustration

Assessment

Assessment is the act of evaluating a patient's health or motion and determining its importance, size, or value. Assessments compare results to normative data or an ideal model to determine if an aspect of health or motion is contributing to the patient's symptoms or movement impairment. Types of assessments include those to clear a patient for intervention, highlight contraindications, or refine exercise/intervention selection. Examples include special tests in orthopedic medicine and goniometry. Synonyms for assessment include evaluation and testing. Related terms include diagnosis, treatment, and rehabilitation.

Assessment

Assessment: is the act of assessing, i.e. determining the importance, size, or value of - In most cases, the results of an assessment are compared to normative data. If the individual exhibits values that are within normal parameters, it may be assumed that the aspect of health or motion assessed is not contributing to the patient's complaint, symptoms, or movement impairment. If the results fall outside of normal parameters, it may indicate that the aspect of health or motion assessed is contributing to, or being affected by the patient/client's complaint, symptoms, or movement impairment. In some cases, the results of an assessment are compared to an "ideal model." In this case, deviations from the ideal are noted as potential issues. For example, deviations noted in the Overhead Squat Assessment are compared to an "ideal model" of posture and motion. Assessments used by human movement professionals can be divided into three broad categories:

  • "Clear" the Patient/Client for Intervention - These are tests, assessments and evaluations used to determine if a patient/client's issue may improve given the assessing professional's scope, skills, abilities, and willingness to treat that individual.
    • For example, many of the special tests used in orthopedic medicine assist in determining the level of pathology or likelihood of a particular diagnosis. Certain issues and diagnoses are beyond the scope of the human movement professional, and are better treated by diagnostic professionals in the medical community (physicians, podiatrists, surgeons, etc.). A Calf Squeeze (Thompson) Test is one example, in which a positive sign may indicate a rupture of the Achilles tendon that may be better treated via surgical intervention.
  • Highlight Contraindications - Tests, assessments and evaluations used to stratify risk or preclude a professional from addressing certain tissues, motions or using a particular technique.
    • For example, the Vertebral Artery Test (VBI) is often used to determine if high velocity thrust mobilizations (manipulations) are safe for a patient with cervical dysfunction.
  • Refine Exercise/Intervention Selection: Tests, assessments and evaluations used to assist the professional in determining which techniques, modalities and exercises will best address a patient/client's complaints or desired goals.
    • Most movement assessments fall into this category. For example, a positive Ely's Test may indicate a need to release and/or lengthen the rectus femoris .

Note: An assessment, or assessment result, may fall into more than one category. For example, although goniometry is an assessment most often used to refine exercise/intervention selection, if a range of motion is significantly altered, with an abnormal end-feel, and/or causes the patient or client/pain, the individual may need to be referred to a physician for further testing and clearance to resume rehab activities. Further, that same patient may return to the human movement professional with a list of contraindicated activities from the physician. - "When in doubt, refer out!"

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