Sharpen Your Skills

Highly successful therapists have something in common: exceptional skills in observation. The sharper your observation skills: the more effective your treatment will be. Observation includes what you see, what you hear and what you feel. For more in-depth tips
on sharpening your
observation skills, view
this sample taken from
the workbook "Functional Treatment
Ideas & Strategies
in Adult Hemiplegia"
(652 KB PDF)
Observation: What do you see?
Begin by positioning yourself on your patient’s weak side. Is there any neglect or disregard of their involved side? Look carefully for any clues to help determine problem areas that affect their ability to function. How are they dressed? Do they have any special equipment?		 Observation: What do you see?
Observation: What do you hear?
Continue to gather important information throughout the interview process. What are your patient’s goals? How do they describe their problems? Develop a rapport with your patient and begin to establish trust before initiating more formal tests.		 Observation: What do you hear?

What Do You Feel?
I call this tactile observation. This is a very important part of your evaluation, it is just as important as visual observation.

Now, as you begin your ‘hands on’ therapy, you begin to build trust with your patient. This is more comfortable for my patient if I begin distally rather than proximally. Your hands should be firm but never forceful. Say to your patient: “If anything hurts, let me know.”

 

 What do you feel?
Palpate the muscle
As you move more proximally during your assessment, how does the muscle bulk feel? Firm? Tense? Soft? Specific problem areas related to ROM, motor control and joint pain are easier to identify when extra layers of clothing are removed.		 What do you feel?
Move the limb
How does it feel? Light? Heavy? Resistive? Are you able to move the limb through full passive ROM? How does it feel at end range? Blocking? Soft? Are there any complaints of pain?		 What do you feel?
Observations During Functional Tasks
Don’t forget to observe your patient doing functional tasks. Not only are they more complex in terms of motor control, you’ll begin to assess cognitive and perceptual functions, as well.		 What do you feel?
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