Student Name and Number
Assessor’s Name
Passing Grad:
Physical Therapist Technician
Application of Orthopaedic Equipment
Clinical Assessment
Materials
a)
b)
c)
d)
e)
f)
g)
h)
Patient case study
Pen
Paper (checklist for assessor and blank for student)
Treatment materials:
I. Axillary crutches
Chair
Stairs
Hand sanitizer
Simulated patient
Facility Instructions
This EC shall be completed in one of two settings:
a) The physical therapy clinic at the Polyclinic; or
b) The physical therapy classroom at the AFAMS school house once the equipment on
order has arrived and has been set up for student use.
Arrangements and Procedures
Practical EC: The student will enter the assessment room where there will be the assessor and a
simulated patient in a chair. The assessor will read the scenario from a piece of paper to the
student and will then make it accessible for the student to reference during the assessment.
Students shall receive 5 minutes to prepare the room and equipment. They will then have 20
minutes to perform the given task(s). Students will complete this EC with due regard to all
safety procedures ensuring they ask about contraindications/precautions to which the
simulated patient will have none. If at any time during the assessment the assessor feels the
patient’s safety is at risk, the student will be instructed to stop immediately, de-briefed on the
safety infraction and will be rescheduled for retesting.
Grading Scheme
This EC consists of a pass/fail checklist. The student must perform all points on the checklist to
successfully pass this EC. If they are not successful, they must be tested again.
Student Name and Number
Assessor’s Name
Passing Grad:
Trainee Instructions
The assessor will read a scenario and then provide a copy for reference. You will have 5 minutes
to review the case and prepare for the assessment and 20 minutes to perform the assessment.
All the materials that you will need for the assessment will be provided for you.
SCENARIO
A 20 year old male is referred to physical therapy for a left lateral ankle sprain. The doctor has
ordered that the patient be fitted with axillary crutches for 2 weeks. His weight bearing status is
partial weight bearing. Fit the patient with the crutches, instruct him how to use them properly
for:
-Gait
-Sit ↔ Stand transfers
-Staris
Subjective History Information:
Chief complaint is left lateral ankle pain. Examined by the doctor today who diagnosed him with
a left lateral ankle sprain. Pain started yesterday when the patient rolled over on his ankle
when jumping down from a vehicle. As he jumped down, he landed on his left ankle rolling it
over into inversion. He had pain immediately after the injury to the entire ankle. He did not
hear a “pop.” Was able to partially weight bear immediately after the injury but with a
significant limp. Overnight, his ankle has become quite swollen, bruised and painful. The pain is
to the top of the foot, the lateral ankle and can radiate posteriorly. The pain is a constant ache
and throb and increases significantly in intensity to sharp pain with certain movements.
Aggravated by walking, stairs, pivoting, wearing a shoe, and toe stance. Pain is decreased with
sitting, elevation, ice and rest. On a scale of 1-10, pain is a 7/10 at its worse and 3/10 at its best.
Has taken Tylenol and NSAIDs which provides some relief. No previous ankle injuries. Patient is
an ANA driver. Consents to the objective exam.
Special Questions:
o
o
o
o
Onset (mechanism of injury)? Jump landing and roll
Present for how long? 1 day
Any phases/cyclical nature to the pain? NO
Any previous investigations/treatments> NO
Student Name and Number
Assessor’s Name
Passing Grad:
Red Flag Questions:
o Ottawa Ankle Rules?
o Pain in malleolar zone and tip of lateral malleolus
o Was able to weight bear after initial injury
o Any recent unexplained weight loss/gain? NO
o Any disturbed sleep/night pain? NO
o Hot sweats? NO
o Any of the 5D’s: drop attacks, dysarthria, dyspraxia, dysphasia, dizziness? NO
o Any bowel/bladder problems? NO
o Any gait problems/numbness in hands or feet? NO
o Any weakness or giving way in legs? NO
Objective Exam Information:
o Decreased weight bearing on left in standing, decreased stance phase on left during gait,
calcaneal valgum, ++ swelling to foot and ankle, bruising to lateral foot, between toes and
posterior ankle
o On palpation, ++ tenderness over lateral malleolus, inferior and anterior to malleolus
o Knee AROM: full all directions, no pain
o Ankle AROM:
o Decreased plantar flexion, dorsi flexion and inversion with ++ pain
o Normal eversion with mild pain
o Ankle PROM:
o Pain and swelling limited plantar and dorsi flexion, and inversion with ++ pain
o Ankle strength testing:
o 4/5 dorsi flexion and eversion with pain
o 3/5 plantar flexion and inversion with ++pain
o Neuro exam:
o Normal dermatomes
o Normal myotomes
o Normal reflexes
o Special test:
o +ve anterior drawer with pain
o +ve lateral ligament stress testing in neutral and plantar flexion with pain and laxity
Student Name and Number
Assessor’s Name
Passing Grad:
Physical Therapist Technician
Orthopaedic Equipment Clinical Assessment
CHECKLIST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Confirm patient identification and
diagnosis
Confirm patients chief complaint
and WB status
Identify appropriate treatment plan
as per initial assessment
Select appropriate gait aid (Axillary
crutches)
Inspect gait aid for any worn parts
or safety concerns
Explain the benefits and rationale of
the gait aid
Use appropriate infection control
procedures for patient care (hand
washing and equipment cleaning)
Size the gait aid handles to the
patient’s height (handles at wrist
crease)
Ensure crutches are 2-3 finger
widths from axilla
Demonstrate and educate on gait
pattern and WB status
Have the patient practice walking
with gait aid
Provide the patient with feedback
as required to correct technique
Educate and demonstrate patient
on sit ↔ stand
Practice sit ↔ stand with patient
and provide feedback
Educate and demonstrate patient
on stairs (good go up, bad go down)
Practice stairs with patients and
provide feedback
Ensure patient is ambulating safely
before leaving
YES NO
COMMENTS
Student Name and Number
Assessor’s Name
Passing Grad:
18 Provide patient with any advise and
take-home instructions
19 Record what gait aid the patient
received in the patient’s chart
Overall Assessment:
PASS
Student’s Signature
Date:
FAIL
Assessor’s Signature