I need some clarification on how one would use this approach to
develop a specific diagnosis leading to a prognosis and treatment
approach.
For example, let's start with an orthopaedic problem:
gastrocnemius rupture. The complete rupture is missed on
occassion and yet the clinical tests are quite conclusive. I don't
understand if this approach is appropriate.
As another example, a peripheral nerve impingement such as long
thoracic nerve would also be difficult to assess without specific
muscle tests of the serratus anterior.
In the two situations here I have gone from a top down approach
but in the clinic it is usually a bottom up method. I would
attempt to deduce the anatomical region of interest by
differentiating related unaffected and affected
structures. It seems as if the approach here is not much
different in terms of the overall goal.
Do electrophysiological tests and imaging fit into the "muscle
apartheid" category of tests?
What diagnostic classification system is used in this approach?
My concern would be that in many disease and injury situations
compensatory mechanisms can prevent a clear identification of the
functional status of the underlying component parts. Function is
defined here as the mechanism by which a structure achieves its
role.
Murray
>
> Indeed, it can be most inappropriate and misleading to attribute some
> neuromotor or neuromuscular problem to some single muscle or other soft
> tissue structure. Often, a great deal more circumspection needs to be
> exercised when applying 'muscle tests' too literally and too
> isolationistically. This overemphasis on isolation testing in some ways
> seems to constitute a type of "muscle apartheid".
>
> Dr Mel C Siff
> Denver, USA
> [log in to unmask]
>
>
--
________________________________________________________________
Murray Maitland PhD PT
Associate Professor and Physical Therapist
Faculty of Kinesiology
Sport Medicine Centre
University of Calgary
2500 University Drive NW
Calgary, Alberta
T2N 1N4
(403) 220-8943 office
(403) 220-8232 clinic
(403) 282-6170 fax
[log in to unmask]
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|