Week Two: Clinician vs. Patient Outcome Measurements & Nomenclature

Client Outcomes vs. Patient Outcomes

Outcome measures used to assess the effects of healthcare interventions from either the clinician's perspective or the patient's perspective

Disease-Oriented Outcomes

Measures that focus on characteristics of a disease or injury, such as ROM, blood pressure, strength, or bone density

Patient-Oriented Evidence (POEMs)

Highly subjective measures that assess health status, quality of life, function, and risk of morbidity or mortality

Clinician-Based Measures

Outcome measures collected by the clinician, including ROM, strength, speed, and reaction time

Patient-Based Measures

Outcome measures completed by the patient through surveys, questionnaires, interviews, or self-report forms

Disease-Specific Outcome Measures

Patient-based measures focused on function and symptoms related to a specific disease, injury, or disorder

KOOS (Knee Injury and Osteoarthritis Outcome Score)

A disease-specific questionnaire assessing knee-related symptoms and function

Region-Specific Outcome Measures

Questionnaires that assess functional limitations associated with a specific body region

FAAM (Foot and Ankle Ability Measure)

A region-specific questionnaire assessing foot and ankle function

DASH (Disabilities of the Arm, Shoulder, and Hand)

A region-specific questionnaire evaluating upper-extremity disability

Oswestry Low Back Pain Disability Questionnaire

A region-specific measure assessing disability related to low back pain

Dimension-Specific Outcome Measures

Measures focused on a single aspect of health, such as pain or cognition

McGill Pain Questionnaire

A dimension-specific questionnaire that evaluates pain

Standardized Assessment of Concussion (SAC)

A dimension-specific measure assessing cognitive function after concussion

Generic Outcome Measures

Broad assessments of overall health status and quality of life that are not specific to any disease or body region

SF-36 (Short Form-36)

A generic outcome measure evaluating overall health-related quality of life

Disablement in the Physically Active Scale (DPA)

A generic outcome measure assessing health and disability in physically active individuals

Global Rating of Change (GRC)

A measure that assesses whether patients feel better, worse, or the same after treatment

Summary Scales

Very brief health assessments consisting of one or two questions about health or disability

Ligament

Dense connective tissue composed primarily of collagen and elastin that connects bones and helps stabilize joints

Function of Ligaments

To guide and control joint motion

Intracapsular Ligament

A ligament located within a joint capsule

Extracapsular Ligament

A ligament located outside a joint capsule

Ligament Sprain

An injury involving stretching or tearing of a ligament

Tenderness to Palpation (TTP)

Pain or tenderness when a structure is palpated

Joint Laxity

Excessive movement within a joint due to ligament injury or insufficiency

Hypermobility

Increased joint motion beyond normal limits

Ecchymosis

Bruising caused by bleeding beneath the skin

Grade I Sprain

Mild ligament injury with minimal laxity and inflammation

Grade II Sprain

Partial ligament tear with moderate laxity, pain, swelling, and ecchymosis

Grade III Sprain

Complete ligament rupture with significant laxity and instability

Dislocation

Complete loss of joint congruency, often accompanied by deformity and loss of function

Subluxation

Partial loss of joint congruency that often resembles a severe Grade III sprain

Apprehension Sign

Patient fear or concern that a joint may dislocate during testing

Tendon

Dense connective tissue that connects muscle to bone and transmits muscular force

Tendinitis

Inflammation within a tendon

Tenosynovitis

Inflammation of a tendon sheath

Tendinosis

Degenerative tendon changes characterized by thickening and disorganized tissue

Tendinopathy

General term describing tendon pathology, including inflammatory and degenerative conditions

Crepitus

A grinding or crackling sensation that may be felt during movement

Tendon Rupture

Complete tearing of a tendon, resulting in major weakness and possible deformity

Muscle

Specialized tissue composed of actin and myosin filaments that generate force

Muscle Strain

Injury caused by overstretching a muscle or excessive force during contraction

Grade I Strain

Mild muscle injury with minimal tissue damage

Grade II Strain

Partial muscle tear with pain, weakness, and possible ecchymosis

Grade III Strain

Complete muscle rupture with severe weakness and loss of function

Postural Muscles

Muscles that are prone to becoming tight

Phasic Muscles

Muscles that are prone to becoming weak

Muscle Tightness

Reduced muscle extensibility that limits movement

Muscle Weakness

Reduced ability of a muscle to generate force

Bursa

A fluid-filled synovial sac that reduces friction between tissues

Bursitis

Inflammation of a bursa caused by repetitive shear forces or irritation

Contusion

A bruise caused by direct compression forces to soft tissue

Heterotopic Ossification

Abnormal bone formation within soft tissues, often after severe contusions

Cartilage

Specialized connective tissue designed to resist compression and reduce friction

Fibrocartilage

Cartilage found in structures such as menisci, discs, and labra that absorbs force and provides stability

Articular Cartilage

Cartilage covering the ends of bones in synovial joints that decreases friction and facilitates movement

Osteochondral Defect

Damage or tearing of articular cartilage, often associated with a fracture

Osteochondritis Dissecans (OCD)

A condition involving ischemic changes that can create a free-floating fragment of cartilage and bone

Osteoarthritis (OA)

Long-term degeneration of articular cartilage leading to joint pain and dysfunction

Post-Traumatic Osteoarthritis (PTOA)

Osteoarthritis that develops after a joint injury

Springy Block

A soft mechanical restriction felt during ROM testing, often associated with cartilage injury

Nerve

A structure composed of sensory (afferent) and motor (efferent) fibers that transmit information throughout the body

Afferent Neuron

A sensory neuron that carries information toward the CNS

Efferent Neuron

A motor neuron that carries information away from the CNS

Neurapraxia

The mildest nerve injury involving temporary conduction block without axonal damage

Axonotmesis

Nerve injury involving axonal disruption with preservation of connective tissue structures

Neurotmesis

Complete severance of a nerve with loss of continuity

Paresthesia

Abnormal sensation such as tingling or pins-and-needles

Anesthesia

Complete loss of sensation

Dermatome

Area of skin supplied by a single spinal nerve root

Myotome

Group of muscles supplied by a single spinal nerve root

Upper Motor Neuron (UMN) Lesion

Injury to motor pathways within the CNS causing spasticity or rigidity

Lower Motor Neuron (LMN) Lesion

Injury to motor pathways outside the CNS causing flaccidity and weakness

Spasticity

Increased muscle tone resulting from UMN injury

Flaccidity

Decreased muscle tone resulting from LMN injury

Bone

Highly vascularized connective tissue designed to resist compressive forces

Fracture

A break in the continuity of bone

Simple (Closed) Fracture

A fracture in which the skin remains intact

Open Fracture

A fracture in which the bone penetrates the skin

Spiral Fracture

A fracture caused by a twisting force

Comminuted Fracture

A fracture in which the bone breaks into multiple fragments

Impacted Fracture

A fracture in which bone fragments are driven into one another

Epiphyseal Fracture

A fracture involving a growth plate

Greenstick Fracture

An incomplete fracture commonly seen in children

Depressed Fracture

A fracture where a portion of bone is pushed inward

Point Tenderness

Localized pain directly over a bone injury

Hard End-Feel

An abrupt, firm end range often associated with bone-to-bone contact or fracture

AROM (Active Range of Motion)

Movement produced by the patient's own muscle contraction

PROM (Passive Range of Motion)

Movement performed by an examiner without muscle contraction by the patient

RROM (Resisted Range of Motion)

Movement tested against external resistance to assess muscle and tendon function

MMT (Manual Muscle Testing)

A clinical assessment used to evaluate muscle strength

ROM (Range of Motion)

The amount of movement available at a joint