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  <head>
    <title>072-02 History, examination, diagnostic strategy, differential diagnosis, and common disease</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Rehabilitation assessment and diagnosis">
      <outline text="Functional history in real environments">
        <outline text="Functional diagnosis supplements disease diagnosis">
          <outline text="Same lesion, very different lives"/>
        </outline>
        <outline text="Pre-morbid function, trajectory, assistance"/>
        <outline text="Type of help">
          <outline text="Supervision, prompting, setup"/>
          <outline text="Physical assistance or complete performance"/>
        </outline>
        <outline text="Fatigue and variability">
          <outline text="Once, but not repeatedly or safely"/>
          <outline text="Good and bad days, near falls"/>
        </outline>
        <outline text="Owning equipment is not correct use"/>
        <outline text="Home layout, steps, bathroom, egress"/>
        <outline text="Caregiver assessed separately">
          <outline text="Assumed unlimited family help is unsafe"/>
        </outline>
      </outline>
      <outline text="Impairment and activity examination">
        <outline text="Neurological and musculoskeletal examination"/>
        <outline text="Manual muscle testing is ordinal">
          <outline text="Misses endurance and small changes"/>
        </outline>
        <outline text="Tone scales conflate neural and mechanical">
          <outline text="Compare velocities, assess fixed range"/>
        </outline>
        <outline text="Electrodiagnosis localises peripheral disease">
          <outline text="Velocity and amplitude: myelin and axon"/>
          <outline text="Denervation evolves, so timing matters"/>
          <outline text="Normal study misses small fibre, central"/>
        </outline>
        <outline text="Cardiopulmonary exercise testing">
          <outline text="Cardiac, pulmonary, peripheral, deconditioning"/>
          <outline text="Field tests depend on pacing, motivation"/>
        </outline>
        <outline text="Observe transfers, turning, gait, stairs">
          <outline text="Gait label should lead to mechanism"/>
        </outline>
        <outline text="Standardised measures">
          <outline text="Floor, ceiling, learning, rater effects"/>
          <outline text="Detectable change: measurement error"/>
          <outline text="Important difference: perceived relevance"/>
        </outline>
        <outline text="Participation beyond physical capacity">
          <outline text="Occupational analysis of valued roles"/>
        </outline>
      </outline>
      <outline text="Falls as a systems failure">
        <outline text="Balance, vision, cognition, pressure, medication"/>
        <outline text="Circumstances, prodrome, witness, getting up"/>
        <outline text="Mechanical fall, syncope, seizure, drop attack"/>
        <outline text="Orthostatic pressure, rhythm, feet, cognition"/>
        <outline text="Review sedatives and antihypertensives"/>
        <outline text="Multifactorial beats be careful"/>
        <outline text="Fracture risk and bone protection"/>
      </outline>
      <outline text="Localising gait disorders">
        <outline text="Hemiparetic: circumduction, equinovarus"/>
        <outline text="Steppage: dorsiflexor weakness"/>
        <outline text="Sensory ataxia worsens without vision"/>
        <outline text="Cerebellar broad; parkinsonian freezing"/>
        <outline text="Antalgic: short stance on painful side"/>
        <outline text="Trendelenburg: hip-abductor weakness"/>
        <outline text="Frontal: initiation failure, short steps"/>
        <outline text="Devices">
          <outline text="Cane opposite the painful or weak leg"/>
          <outline text="Poorly sized frame risks tripping"/>
        </outline>
      </outline>
      <outline text="Cognition, communication, swallowing">
        <outline text="Screening, then domain-specific testing"/>
        <outline text="Capacity is decision-specific"/>
        <outline text="Aphasia: fluency, comprehension, naming">
          <outline text="Speaking loudly does not help"/>
        </outline>
        <outline text="Dysarthria: respiration to prosody"/>
        <outline text="Swallowing">
          <outline text="Cough, wet voice, weight loss, pneumonia"/>
          <outline text="Bedside cannot exclude silent aspiration"/>
          <outline text="Videofluoroscopy or endoscopy tests strategy"/>
        </outline>
      </outline>
      <outline text="Pressure, skin, seating">
        <outline text="Load, duration, shear, moisture, perfusion"/>
        <outline text="Dark skin: warmth, firmness, texture"/>
        <outline text="Risk scales support, not replace"/>
        <outline text="Do not massage damaged tissue"/>
        <outline text="Wheelchair is a mobility system">
          <outline text="Poor fit: pain, deformity, pressure"/>
        </outline>
      </outline>
      <outline text="Autonomic, bowel, bladder, sexual function">
        <outline text="Neurogenic bladder">
          <outline text="High-pressure storage, reflux, renal damage"/>
          <outline text="Symptoms do not show bladder pressure"/>
        </outline>
        <outline text="Neurogenic bowel programme"/>
        <outline text="Sexual function: ask directly"/>
      </outline>
      <outline text="Rehabilitation complications">
        <outline text="New decline has medical causes">
          <outline text="Infection, thrombosis, occult fracture"/>
          <outline text="Not simply poor motivation"/>
        </outline>
        <outline text="Painful swollen limb differential"/>
        <outline text="Impaired communication hides acute disease"/>
      </outline>
      <outline text="Prioritised problem list">
        <outline text="Links impairment to participation and risk"/>
        <outline text="Reversible, compensable, preventable, uncertain"/>
      </outline>
    </outline>
  </body>
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