Guide to Neurological Assessment dwu py 2 student

1. GENERAL NEUROLOGICALGENERAL NEUROLOGICAL
ASSESSMENTASSESSMENT

2. ICF –ICF – International Classification ofInternational Classification of
Functioning, Disability and HealthFunctioning, Disability and Health
• Body structure and functions
– Impairments
• Problems in body function or structure such as a
significant deviation or loss
• Activities
– Is defined as the execution or performance of a
task or action by an individual
• Participation
– Is an individual’s involvement in life situations
in relation to health conditions, body function
and structure, activities and contextual factors.

3. Physiotherapy AssessmentPhysiotherapy Assessment
• Subjective
– Info comes from patient
– Most important is HoPC
• Objective Assessment
– Measurements taken for objective
markers

4. SubjectiveSubjective
AssessmentAssessment
What are theWhat are the
components?components?
General assessmentGeneral assessment

5. NEUROLOGICAL HISTORYNEUROLOGICAL HISTORY
• Age
• Sex
• Handedness
• Occupation
• History of present complaint
• Neurological screening questions
• Past medical history
• Drug, family & social history

6. HoPCHoPC
• Start with open question
• Time and course
– The onset, over few seconds, minutes
hours, days, weeks, etc
• Progression
– Continuous or intermittent, stabilized or
progressed
• Pattern
– Frequency & duration

7. HoPCHoPC
• Also determine aggravating and
relieving factors
• Prior treatment & investigations
• Current neurological state
– Abilities and disabilities
• Hypothesis generation & neurological
symptoms
• Screen for other neurological
symptoms
– Headaches,fits,blackouts,episodes of numbness or tingling

8. ObjectiveObjective
AssessmentAssessment
What are theWhat are the
components?components?

9. Neurological objectiveNeurological objective
AssessmentAssessment
• Speech
– Aphasia – a disorder of speech
– Dysphonia - Disturbance of voice
production
– Dysathria – difficulties at different levels

10. UnconsciousUnconscious
Patient!!!!Patient!!!!
What do we do???What do we do???

11. Mental state and higherMental state and higher
functionfunction
• Mental state
– Mood, vegetative symptoms, delusions,
hallucinations & illusions
• Higher Function
– Attention & orientation, memory,
calculation, abstract thought, spatial,
visual & body perception, Apraxia.

12. AssessmentAssessment
• Divided in 2 parts
– Resuscitation – use neurological ABC
– Examination – follow Glascow Coma
Scale
• Aimed at finding or excluding focal
neurological abnormalities
• Determining the level of consciousness &
neurological function

13. EXAMINATION OF SENSORYEXAMINATION OF SENSORY
FUNCTIONFUNCTION
•Superficial Sensation
•Deep Sensation
•Combined Cortical Sensation

14. MUSCULOSKELETALMUSCULOSKELETAL
EXAMINATIONEXAMINATION
• Observation/Inspection
• Palpation
• Range of Motion
• Muscle Performance
• Special Tests

15. MOTOR FUNCTION EXAMINATIONMOTOR FUNCTION EXAMINATION
• Mental status
• Arousal
• Sensory integrity and integration
• Joint integrity, Postural Alignment
and Mobility
• Tone
Cont…..

16. Cont……….
• Reflex Integrity
• Cranial Nerve Integrity
• Muscle Performance
• Voluntary Movement Patterns
• Functional Task Analysis
• Postural Control and Balance

17. EXAMINATION OFEXAMINATION OF
COORDINATIIONCOORDINATIION
•Equilibrium Coordination
Tests
•Non Equilibrium
Coordination Tests

18. Examination of Gait
The therapist look out forThe therapist look out for
symmetry,symmetry,
duration of swing, and Stanceduration of swing, and Stance
phase, muscle activation around thephase, muscle activation around the
ankles, knees, hips and trunk, armankles, knees, hips and trunk, arm
swing, trunk rotation, balance andswing, trunk rotation, balance and
speed.speed.

19. Examination of Functional
Status and Activity Level

20. REFERENCEREFERENCE
• Fuller.G.(2004).Neurological
Examination made easy.3rd
ed.UK;
Elsevier.
• The rehabilitation specialists
handbook
• Physical Rehabilitation, V Edi., -
Susan B. O’ Sullivan