Neurological Assessment , database, subjective, objective examination.

 Patient present with a variety of conditions, and assessment need to be adapted to suit their needs. This section provides a basic framework for the subjective and objective neurological assessment of patient.

Database:
History of present condition
past medical history
drug history
Results of specific investigation (X- ray, CT scan ,blood tests,etc..,)

Subjective Examination:
 Social situation:
   --Family Support
   --accommodation
   --employment
   --leisure activities
   --social service support.
Normal daily routine
Indoor and outdoor mobility
Continence
Vision 
Hearing
Swallowing
Fatigue
Pain
Other ongoing treatment
Past physiotherapy and response to treatment
Perceptions of own problem/main concern 
Expectations of treatment

Objective examination:

posture and balance
  Alignment
  Neglect
  Sitting balance 
  Standing balance 
     --Romberg's test.

Voluntary movements
 Range of movement
 Strength
 Coordination
    --finger-nose test 
    --heel-shin test
    --rapidly alternating movement 
 Endurance.

Involuntary movement 
  Tremor
  Clonus
  Chorea
  Associated reactions.

Tone
 Decreased/flaccid
 Increased
  --Spasticity(clasp-knife)
  --rigidity (cogwheel or lead-pipe)

Reflexes
 Deep tendon reflexes
   --biceps(C5/6)
   --triceps(C7/8)
   --knee(L3/4)
   --ankle(S1/2)
 Plantar reflex 
 Hoffman's reflex.

Muscle and joint range
  Passive range of movement.

Sensory
  Light touch
  Pin prick
  Two-point discrimination
  Vibration sense
  Joint position sense
  Temperature
  Vision and hearing.

Functional Activities
  Bed mobility
  Sitting balance
  Transfers
  Upper limb functions
  Mobility
  Stairs.

Gait
  Pattern 
  Distance
  Velocity 
  Use of walking aids
  Orthoses
  Assistance from others 

Exercise tolerance/fatigue

Cognitive Status
  Attention
  Orientation
  Memory 

Emotional state



 Thank you

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