Clinical Skills

A sign or symptom that indicates the possible presence of a serious medical condition that could cause irreversable disability or even death if not properly managed

• Persistent night pain • Loss of appetite • Unexplained weight loss • Changes in bladder function • Frequent nausea/vomiting

• Tissue Texture Change • Asymmetry • Range of motion loss • Tenderness The presence of any of these may indicate a muscuoskeletal pathology or condition

• Increased Muscle pain • Joint stiffness/soreness • Tiredness -headaches

• Fracture • Joint Sprain • Stroke • Disc Herniation • Cauda Equina Syndrome (Compression of spinal nerve roots)

• Are treatments that are inadvisable and are permanently recommended against until condition is remediated

• Weak Bone • Non-compliance of patient • Neurological dysfunction • Lack of working diagnoses • Pain/excessive tissue feedback

• Are conditions that can be treated but with caution and the benefits/risks should be considered

• Pregnancy (especially 1st trimester) • Patients age/health status • Active inflammatory disease (Eg: Rheumatoid arthritis) • Acute or chronic systemic disease • Intervertebral Disc Herniation

• Nature and diagnoses of the condition or presenting complaint • Proposed treatment and management plan • Benefits of treatment/management plan • Potential risks associated with treatment • Who will be involved in management (possible co-management) • Other treatment and management plans available including the option for no treatment, taking into account patient preferences

Physiological Barrier

Elastic Barrier

Elastic Barrier

• Skin Temperature • Skin roughness/smoothness • Skin vitality • Skin Thickness • Finger drag • Skin Mobility

5: Normal, complete ROM against gravity with full resistance 4: Good, complete ROM against gravity with some resistance 3: Fair, complete ROM against gravity with no resistance; active ROM 2: Poor,c omplete ROM with some assistance and gravity eliminated 1: Trace, evidence of slight muscular contraction, no joint motion evident 0: Zero, no evidence of muscle contraction

3+: Bounding 2+: Brisk/normal 1+: Weaker/DIminished 0: Absent

0: Absent 1+: minimal/diminished 2+: Normal 3+ Hyperactive without clonus (Involuntary muscle contractions) 4+ Hyperactive with clonus

• Acheive decrease in pain • Promote mobility and movement • Support tissue healing and collagen remodelling • Promote fluid drainage