Inspection
and Palpation for the Exercise Physiologist
Mark
Kaelin, EP, CSCS
Exercise Physiologist
Southern Indiana Rehab Hospital
3104 Blackiston Blvd
New Albany, IN 47150
In the final of three-part series
on physical assessment, a review of inspection and palpation will
be provided. These two components of one’s initial evaluation are defined
as:
Inspection:
visual examination of the external surface of the body as well as it’s
movements and posture.
Palpation: process
of examining by application of the hands or fingers to the external surface
of the body to detect evidence of disease or abnormalities in the various
organs.(1)
Both of these techniques provide
valuable information in determining limiting factors to functional mobility/exercise
and with developing a plan of treatment to improve these variables with
exercise.
When approaching a client
for the first time, take a moment to ponder the following questions:
1. How
is the client sitting?
2. What is the
client's posture?
3. Does the
client assume the standing position with ease?
4. When walking
with the client to the examination room, note the gait.
5. Is the client's
balance good?
6. Does the
client reach for objects to support the standing position?
7. How does
the client move?
8. Is the client
overly stiff?
9. Are there
signs of tremors?
10. Do you notice the accessory
muscles of breathing used at rest or with activity?
These are just some of the things
you can look for in the first few seconds upon seeing a client/patient.
Taken singly or collectively, the observations can provide valuable insight
about the client's level of conditioning and possible medical complications.
In my current practice, I
use palpation to evaluate breathing mechanics in children and adults with
pulmonary diagnoses. During the evaluation, I will place my hands on the
client's abdomen and rib cage to feel the external intercostals, diaphragm,
internal intercostals and abdominal muscles. Does this client have good
breathing mechanics? Or, does the palpation suggest that this is an area
that needs work?
In conclusion, whether you
work in a hospital, a clinic, or wellness center, it is imperative that
you have strong physical assessment skills. Evaluating clients can be difficult
even more so today, when you might not have as much time to work up a client
as you would like. However, the exercise physiologist who possesses strong
physical assessment skills can perform a very thorough evaluation in a
very short period of time to help insure that the clients visit to the
facility is enjoyable and beneficial.
See
also:
Part I: Physical
Assessment: An Often Over-Looked Portion of Exercise Testing and Prescription
Part II: Auscultation:
Listening to Determine Dysfunction
Reference:
1. Taber’s Cyclopedic Medical
Dictionary (17th edition). Philadelphia: F.A. Davis Company, 1993.
Copyright
©1997-2001 American Society of Exercise Physiologists. All Rights
Reserved.
ASEP
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