What is the first image that comes to mind when I hear that question? For me, it is the roadside test of closing your eyes and touching your nose.
What is an impairment?
The American Medical Association Guides to the Evaluation of Permanent Impairment (AMA guides) define an impairment as “The loss of, loss of use of, or derangement of any body part, system or function.”
Why does the AMA guides definition matter?
Since its inception more than six decades ago, the AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides), has become internationally accepted as a global benchmark and is used in the United States, Canada, certain European countries, the Middle East, Australia, New Zealand, and Southern Africa, as well as by the United Nations. Most workers’ compensation jurisdictions across Canada use the AMA Guides formally by statute, and they are embedded in most auto and long term disability insurance systems.
How is the level of impairment determined?
Since an impairment is a loss, the level of impairment is determined through a comparison to what is normal. For physical impairments, the AMA Guides includes normal range of motion values. Normal shoulder flexion is listed as 180°. Iif the patient’s shoulder flexion is less than the normal 180° , say only 90°, the patient would have an impairment.
Why is accurate impairment measurement important?
- aids in planning the appropriate treatment interventions
- provides objective evidence that the patient requires the treatment
- Increases likelihood of treatment reimbursement
- to produce treatment outcome measurement reports
How do you measure range of motion?
A goniometer is the most common tool used to measure extremity range of motion. A digital goniometer is easier to read, more accurate¹ and only slightly more expensive than the traditional plastic goniometer.
American Physical Therapy Association (APTA) has encouraged the integration of technology into the practice of physical therapy, because of its impact on the profession and patients by improving the treatment outcomes and/or reducing the costs of treatment.³
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- Hancock GE, Hepworth T, Wembridge K. Accuracy and reliability of knee goniometry methods. J Exp Orthop. 2018;5(1):46. doi:10.1186/s40634-018-0161-5
- Roach, S., San Juan, J. G., Suprak, D. N., & Lyda, M. (2013). Concurrent validity of digital inclinometer and universal goniometer in assessing passive hip mobility in healthy subjects. International Journal of Sports Physical Therapy, 8(5), 680.
- Swisher, L. L., & Hiller, P. (2010). The revised APTA code of ethics for the physical therapist and standards of ethical conduct for the physical therapist assistant: theory, purpose, process, and significance. Physical Therapy, 90(5), 803-824. doi: 10.2522/ptj.20090373