Answer 4

  • Continue with objective
  • Wash hands
  • Gain informed consent and ensure that the patient has capacity to make a decision. 
  • Cognition
    • Make sure patient is oriented to person, place and time
  • Observation
    • Fasciculations
    • Atrophy
    • Positioning of extremities 
    • Edema 
    • Compare side to side
  • Range of motion
    • Check range of motion of each joint. 
    • Once done range of motion, assess tone and spasticity
    • Use the modified ashworth scale. 
  • Strength
    • Global strength in hip flexion, hip extension, knee flexion, knee extension, ankle dorsiflexion, plantarflexion, shoulder flexion, extension, abduction, and adduction. 
    • Make sure to clarify that you would only perform these movements as it would give you more insight into how they would transfer and how it would inform your treatment. 
  • Neurological Scan
    • Myotomes
    • Dermatomes
    • Reflexes 
    • Superficial Sensation
    • Deep sensation
    • Vibration
    • Temperature
  • Coordination
    • Dysmetria
    • Dysdiadokinesia
    • Dyssynergia 
  • Posture/Gait and balance
    • It would be difficult to assess these at the moment since Gene has not mobilized yet so she may be fairly deconditioned. It would be important to assess sitting balance and, if it was safe to do so, gait with an aid.