P: pain/tenderness in terms of location,

quality and intensity. Identified by using 1 or

more of the following:
observation – pain that the patient exhibits during the
course of the
examination. Note the location, quality and severity of the
pain
(percussion, palpation or provocation) when examining

A:
asymmetry/misalignment identified on a
sectional or segmental level
observation - patient posture or analyzed gait;

static and dynamic palpation – describe the spinal

misaligned
vertebrae and symmetry;

diagnostic imaging – x-ray, CAT scan, MRI;

R: range of motion abnormality

 observation – increase or decrease in patient’s range of
motion;
 motion palpation – palpation findings (note areas involved
and related to
regions manipulated);
 stress diagnosing imaging – x-rays using bending views;
  range of motion measuring devices – goniometers or
inclinometers
 recording specific measurements.

T: tissue, tone changes in the characteristics of
contiguous, or associated soft tissues including skin,
fascia, muscle, and ligament.
 observation – visible changes such as signs of spasm,
inflammation,
 swelling, rigidity

 palpation – changes in tissue such as hypertonicity,

hypotonicity, spasm,
 inflammation, tautness, rigidity, flaccidity

 use of instrumentation – document instrument used and

findings

 tests for length and strength – document leg length, scoliosis

contracture
 and strength of muscles that relate