PCM Model
What occurs in the examination phase
1)Hx (investigation of systems + Review of systems)
2)Systems review ( what is in our scope + hands on patient screening)
3) Test and Measures ( MMT,Goni, Vitals)
What is apart of the contextual realm of this model
Environment + Personal factors
Where in the SOAP note would you document progression within the plan of care
Assessment
What is the only Primary vital sign that does not trend down
Blood Pressure
You want to check a patients left hip flexion using your goniometer. you ask them to lay supine because you know that is standardized positioning, but they tell you they can not. so you ok, we'll do it sitting. you tell them to raise their leg into hip flexion and you notice they are grimacing and you ask them how they are feeling and they say I am feeling a 10/10 pain. you get your measurements and tell them to put their leg down.
what needs to be documented from this part of the session.
What is happening in the evaluation phase
Making sense of data using your clinical judgement
closely related to Diagnosis and Prognosis
What are the parts of the functioning and disability realm + Example
impairments
Activity Limitation
Participation Restriction
Health Conditions
Where in the SOAP note would you document factors that modified the intensity of the interventions implemented today
Assessment
Common factors affecting vital signs
-Measurements are specific to an individual
-Individuals may have different baseline values compared to the normative values for many reasons
you then want to do another gross muscle strength test to locate any areas of weakness in the region and you do it in a position of convenience. what test did you just perform
Functional muscle strength testing
Static resisted test
What has to be incorporated when forming a Prognosis
time frame, functional outcomes around activity limitations, and contextual factors
what is the difference between a health condition and an impairment
Impairments are problems at tissue/ biological level (pain,welling,balance) , while health conditions are problems that are considered a medical diagnosis (total Knee Arthroplasty)
Where in the SOAP note would you document interventions provided during your session
Objective
What structure in the heart are we measuring when we are checking a patients pulse
Left Ventricle contraction
your patient is able to go through full range in the horizontal position, but less than half the range in the gravity resistant position. what MMT grade do they get
2+
What has to be incorporated when forming a diagnosis
Impairments + Activity Limitation +*Participation Restriction
How do contextual factors interact with functioning and disability factors
Contextual factors help us understand patients, so that we are able gear their interventions more towards them.
Where in the SOAP note would you document changes in the patient status since the last visit
Subjective
other than the number of beats you feel what else are you monitoring when checking heart rate (pulse)
Rhythm: intervals between beats
volume (quality): blood volume per beat
MMT has a good [ ] reliability and a variable [ ] reliability
intrarater, interrated
What sorts of interventions can we give
interventions could be: education, giving equipment, TherX, and/or hands on treatment
Match these examples with their proper ICF component
stiffness
can't drive kids to school
unable to eat without assistance
Ethnicity
how much recreation they do
torn rotator cuff
Impairment
Participation Restriction
Activity limitation
Personal factor
environmental factor
health conditions
Where would you put patients future progressions
plan of care for future visits
A patient comes to you with a 2+ grade pulse how much pressure did you have to apply to obliterate their pulse.
Oh no! the patients mom has passed out. you check her pulse and its very hyperactive and you can't obliterate it with moderate pressure like a normal pulse. what grade pulse would you give her
patient: light pressure
Patients mother: 4+ bounding
your patient has full range of motion in the horizontal plane and more than half the range of motion in the gravity resistant plane. what is there MMT score
3-