Subjective assessment



Gathering information in the subjective assessment

The subjective assessment should be used to gather information about the movements and activities the person is having difficulty with, and the muscle groups you need to assess.

Remember, there is more information about subjective assessment in ‘Introduction to rehabilitation’ module.


Question

Image of Sofia

Remember Sofia?

Sofia loves gardening, but recently she has been feeling unsteady on her feet when gardening and does not feel confident when she doesn’t have something solid to hold onto. Sofia has previously been prescribed a walking stick, she says that this helps to maintain her balance

She has presented to the clinic for another health matter, however mentions her issues with balance during the appointment.

As the clinician, you express you may be able to help Sofia with her balance through muscle strengthening exercises and she agrees that this would be helpful for her.


Read the following discussion between a clinician and Sofia.

Clinician: ‘Have you fallen or lost balance in the past 12 months’

Sofia: ‘No I haven’t fallen over, but I don’t like moving around too far away from something I can hold on to’


Clinician: ‘Okay, how about when you go into your garden, how do you get there?’

Sofia: ‘I usually hold onto the walls or tables in my house, but when I am trying to do gardening there is nothing to hold onto and I feel unsteady.’


Clinician: ‘Okay, do you have any difficulty using your hands and arms at all?’

Sofia: ‘No they are okay.’


Clinician: ‘Great, are you in any pain at all, anywhere in your body?’

From this example, what are some of the muscle groups that you might want to assess Sofia’s muscle strength?

Select all that apply.

  •  a. Hips
  •  b. Knees
  •  c. Ankles
  •  d. Trunk

All are correct.

Sofia has described difficulties with balance. Trunk and leg muscles are important for balance. It would be appropriate to assess all muscle groups in Sofia’s legs on both sides and her trunk muscles.


Question

Nguyen and her son sitting and talking with a clinician

Remember Nguyen? 

Nguyen experienced a stroke leaving her with weakness in his left arm and leg. Nguyen has been doing muscle strengthening exercises as part of a rehabilitation program. Nguyen would like to be able to return to her duties as president of her local community group. This involves having to walk around the kitchen and prepare meals.


Read the following discussion between a clinician and Nguyen.

 

Clinician: ‘Do you have difficulty doing anything around your home?’

Nguyen: ‘Since doing more muscles strengthening exercises, the strength in my left arm and hand have improved greatly. However, I am left handed and I still have difficulty doing some things.’..

Clinician: ‘Okay, can you think of any examples of things you find difficult?

Nguyen: ‘Yes I find doing my hair difficult. I also find holding heavy shopping bags with my left hand difficult.’

From this example, what are some of the muscle groups that you might want to assess muscle strength?

Select all that apply.

  •  a. Shoulders
  •  b. Elbows
  •  c. Wrist
  •  d. Hand

All are correct.

Nguyen has difficulty using her left arm and hand and has described how that affects functional activities in her life. It would be appropriate to assess all muscle groups in her arm and hand, and compare that to the other side.