On this new prac I have received a patient that I was told to treat without an initial assessment. I have since been able to assess this patient and have continued treatment based around increasing muscle strength and progression toward walking with bilateral crutches. His condition is basically non-resolving so what he has got now in terms of strength is what he will effectively remain with, give or take some small increases.
After manual muscle testing I graded 1 key muscle in particular as a grade 2 bilaterally. I then saw this patient with my supervisor (1 week later) who also performed the test again and found one side to be a 2 and one side to be a 0, meaning that my goals for function needed to be adjusted and so too my treatment plans (thanks to the local muscles tricking me).
I have always thought of accurate assessment o be important to guide treatment, but this has emphasised that fact. Had I not had the supervisor look at this patient, assessment I could well have spent 4 weeks trying to strengthen a muscle which isn’t innervated and working toward a function they may never have achieved This has emphasised the importance of careful and accurate. Definitely something to keep in the back of my mind now.
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2 comments:
I agree, I think sometimes we get a little caught up in estimating things, thinking that it doesnt really effect whatever treatment we will use. But you've shown that with some patients you do need to be a little more accurate with measurements as it may significantly alter your treatment. I think we all need to keep it in the back of our minds.
this happened to another student and I on a recent prac, and we learnt that it is so important to be accurate, but also very difficult to be when really MMT should be one of the most simple things we do. So many factors come into play, and every one grade them differently. when unsure, its always worth asking for a second/third opinion if need be. not for every muscle ofcourse, just the key ones to the goals your trying to achieve
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