Wash hands Explain procedure, ask for consent Inspection o End of bed – obvious signs of distress, walking aids etc Gait o Watch patient standing up – observe posture and steadiness o Ask patient to walk to other side of room and back Looking for any changes in stance, arm swinging, shuffling, waddling etc o Ask patient to walk heel-to-toe – exaggerated unsteadiness in cerebellar problems o Romberg’s test – ask patient to stand with feet close together, arms by their sides and close eyes – keep as still as possible. +ve test indicates proprioceptive problem Stand close to pt in case they fall Speech o Ask patient to repeat “british constitution” and/or “baby hippopotamus” Nystagmus o Do the H pattern – looking for nystagmus at ends of vision Arms o Observe for resting tremor “rest hands on your lap and close your eyes” or “hold your hands out straight while I rest this piece of paper on them” o Observe for intention tremor - e.g. remove watch, write sentence o Examine muscle tone – tell patient to fully relax and put joints through full ROM – elbow flex/extend, wrist flex/extend/adduct/abduct o Test for dysdiadochokinesis o Finger-to-nose test – “can you touch your nose, then my finger, and keep doing that” o Fine finger movements – get pt to oppose thumb with each finger in turn as fast as possible o Test for reflexes (biceps, triceps, supinator) or state would normally do so Legs o Repeat tone and reflexes if necessary o Heel-to-shin test Thank the patient Wash hands
If they could talk about walking again: Canine Cruciate Surgery Rehabilitation Program: A 10 week detailed program of specific approaches, exercises, massage, and restoring balance to get the best results after your pet has undergone surgery for cruciate ligament repair. Tracking sheets for each week.