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Upon completion of this chapter, the learner should be able to:
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Discuss the three main categories of medical diagnostic tests.
Discuss the main diagnostic tests within each category, including major indications and results.
Recognize and interpret abnormal test results on a formal test report.
Contrast the purposes of the different types of diagnostic imaging studies.
Describe the procedure and expected results for nerve conduction studies and electromyography.
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Celene Darby, a 46 year-old female with diabetes, is your patient in an outpatient clinic and is telling you about her hospital stay. When you ask about medical tests she had during the hospitalization for hemorrhagic stroke, she says “I can’t count the number of tests I had in that hospital.” Computerized tomography (CT) scans had confirmed the size and location of the cerebrovascular accident (CVA) and because of the recognized hemorrhage, verified she was not a candidate for thrombolytic intervention (tPA). She also had frequent blood tests to monitor the degree of anemia. And throughout the stay, because she was not eating or drinking well, she had numerous serum chemistries run to monitor her fluid status and blood glucose. Taking this part of the patient history gives you a better understanding of some of the potential complications in this patient during her therapeutic activities.
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Physical therapists (PTs) and occupational therapists (OTs) increasingly practice in more acute settings and provide intervention to patients who are less medically stable. As explained in Chapter 2, the PT does not make a medical diagnosis in the realm of pathology, but instead the PT diagnosis consists of movement-related impairments of body structure/body function and functional limitations of activity. In any case, the therapist will be exposed to (1) printed reports of a variety of medical tests both in the patient record and (2) verbal reports by the patient. The therapist will have to make decisions regarding rehabilitation intervention and medical screening based on the available information. Therefore, it is essential for the therapist to be aware of the variety of tests, their results, and the implications of abnormal values. Medical diagnostic tests, as the name implies, most often serve the purpose of confirming or ruling out a suspected medical diagnosis. In some cases, especially with some clinical laboratory tests, medical test results can be used to (1) support or confirm a medical diagnosis, (2) determine the appropriate medical treatment (including implications for intensity of exercise), and (3) monitor the effectiveness of medical interventions.
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The purpose of this chapter is to provide a brief overview for therapists and therapy students of diagnostic measures used in patients with neuromuscular disorders (both adult and pediatric). Therapists do not diagnose from these tests, but they do need to understand the terminology in each area, be able to interpret written reports, and have a working knowledge of implications of the test ...