SCREENING FOR HEALTH,

FITNESS AND WELLNESS

DANISH LATIF
Screening

 Screening is essentially checking for pathology when there are no

symptoms of disease. A screening often includes simple measures to
identify risk factors for illness and is used to determine the need for
further examination.
 According to the Guide to Physical Therapist Practice, common
screening activities include
i. screening for lifestyle factors (e.g., amount of exercise, stress,
weight)
ii. screening posture for scoliosis.
iii. identifying high risk factors for slipping or falling of older adults.
iv. performing prework screenings to identify risk factors in the
workplace and the health status of potential workers.
 Examination

 Examination in physical therapy practice includes

 taking the client's history
 reviewing the body systems for potential pathology, and
performing specific tests and measures guided by the
initial screening, patient/client history, professional
judgment, and relevant clinical findings.
 Evaluation

 Evaluation, according to the Guide to Physical Therapist

Practice,* is "the process in which the physical therapist
makes clinical judgments based on data gathered during
the examination
 Nonverbal communication

 Appropriate interpersonal skills are essential to

developing report with an individual during the screening
process.
 The interviewer must be a good listener and have the
ability to focus energy, attention and thoughts on what the
individual is saying.
 nonverbal communication
 Five skills, if used effectively, can improve the enjoyment
and outcome of interpersonal communication:
 (1) eye contact
 (2) body position
 (3) proper distance between the interviewer and
interviewee.
 (4) gestures
 (5) facial expression
Verbal communication
 Verbal communication is critical for eliciting responses
needed for a medical history and identification of health
risks
 Open ended questions/ closed ended.
 Closed-ended questions are those which can be answered
by a simple "yes" or "no," while open-ended
questions are those which require more thought and more
than a simple one-word answer.
 Cont…

 Awareness of the individual's cultural background is

critical to understanding the other person's point of view
and relevant issues; the LEARN model, which emphasizes
listening and sharing similarities and differences, can be
used to effectively used to over­come cultural
communication barriers
The acronym LEARN represents the following key
components of the model:
 L = Listen with sympathy and understanding to the
client's perception of the problem.
 E = Explain your perceptions of the problem.
 A = Acknowledge and discuss the differences and
similarities.
 R = Recommend a course of action.
 N = Negotiate an agreement.
 Using the LEARN model enables the interviewer to
effectively communicate with various individuals.
 Screening for Mental Health

 Mental health is directly or indirectly influenced by multiple

factors, including memory, interpersonal relationships at
work and at home, coping and stress management, social
support, financial support, education, vocation, leisure
activities, and personal values.
 Depression is a significant psychosocial problem affecting
individuals health, fitness and wellness and ultimately, their
quality of life.
 Cont…

During the past month, have you often been bothered

by feeling down, depressed, or hopeless
During the past month, have you often been bothered
by little interest or pleasure in doing things
 Stress Assessment

 During the interview, it is important to note stressors

commonly affecting health status. Stressors include recent
life changes or losses (eg, loss of family or friends,
relocation of home and/or business), changes in marital
status, or significant financial concerns.
 Screening for Substance Abuse

 Physical therapists may note stress behaviors in their clients and

suspect abuse or violence.
 screening test involves only two questions:
 "In the past year, have you ever drunk or used drugs more than you
meant to?" and "Have you felt your wanted or needed to cut down on
your drinking or drug use in the past year?“
 In one study, at least one positive response detected current
substance-use disorders with nearly 80% sensitivity and specificity. As
with all screening tests, performance varies with the prevalence of
substance abuse in the particular population screened.
 Screening for Physical Abuse

 Oftentimes individuals come to a screening to get help but

are embarrassed to admit that they are experiencing
significant psychosocial problems. It is important to
screen for possible violence since an individual may be
experiencing significant stress in personal relationships.
 Cont…
 The following three questions can open up discussion about
potentially life threatening situations and address the issue of
intimate partner violence:

 1. Have you been hit, kicked, punched or otherwise hurt by

someone in the past year?

 2. Do you feel safe in your current relationship?

 3. Is there a partner from a previous relationship who is making

you feel unsafe now?

 A positive screen is a "yes" answer to any of the three

questions.
 Screening for a Balanced Lifestyle

 A wellness screening includes a broad range of questions

reviewing social wellness,
 physical wellness,
 emotional wellness,
 career/leisure wellness,
 intellectual wellness,
 environmental wellness,
 and spiritual wellness.
Physical Health Screening

 General Health
Family History
 Weight
 Blood pressure  Fatigue
 Stroke  Weakness
 Cancer  Malaise __Fever __Illness
 Diabetes  Immunizations history
 Allergies  Birth History
 Arthritis  Medications
 Alcoholism  Medical History
 Mental illness  Serious accidents
 Seizure disorders  Hospitalizations
 Kidney disease  Surgeries
 Other  Serious illness
 General Health

 Mouth and Throat Pain

 Vision…Glasses
 Toothache
 Ears  Lesions or sores on the
 Earaches __Infections • mouth or throat
__Discharge from ear __Ringing  Changes in the mouth or
(tinnilis) __Dizziness (vertigo)
throat…Altered taste…Jaw
pain
 Nose and Sinuses’
 Neck pain
 Discharge from the nose or  Limitations in neck
sinuses __Sinus pain movement
 Lumps, swelling,
 Unusual and frequent colds tenderness, or other
 Change in sense of smell discomfort
 System review
Respiratory System
…H/O asthma …Chest pain…
SOB…Cough___
Wheezing
 Cardiovascular System
…Pain near heart—with or
without exertion _Dizziness
when standing up
 Personal history of any heart
problems
 Problems breathing when
sleeping
 Peripheral Vascular
System
….Coldness __Numbness—
Tingling
__Swelling of legs or hands.
Pain in legs __Discolored
hands or feet…Vericose
veins __
History of vascular problems
 Gastrointestinal System
 Changes in appetite  Frequency of bowel
 Food intolerance movement
 Heartburn  Recent changes in
 Abdominal pain stool…Constipation or
 Nausea and vomiting diarrhea
 Flatulence (gas)  Rectal bleeding
 Rectal conditions
 Use of antacids or
laxatives
 High fiber in diet
 Urinary System

 Frequency of urination.
 urgency
 Pain with urination
 Unusual color
 Other problems
 For women: Kegel exercises post-pregnancy

 Male Genital System

 Sores or lesions __Lumps __.Hernia
 Female Genital System
 Menstrual history (last period, duration; cycle)
 Pregnancy history
Musculoskeletal System

History of OA, RA, gout

 joint pain, swelling, or stiffness, deformity.

 Range of motion limitations

 Muscular pain

 Muscle cramps

 Muscle weakness

 Gait problems

 Problems with coordination

 Back pain Joint stiffness

 Limitations in movement

 History of back problems or disc disease

Neurological System

History of seizures
 Headaches

 Stroke

 tremors

 Paralysis

 Sensory numbness

 tingling

 Memory loss

 Disorientation

 History of mental health dysfunction

 Hematologic System

____Bleeding problems
__Excessive bruising
__Lymph node swelling
__Exposure to toxins and radiation
__Blood transfusions and reactions_________
 Endocrine System
__History of diabetes
__Thyroid disease
__Intolerance to heat and cold
__Change in skin pigmentation and
texture
__Excessive sweating
__Abnormal relationship between
appetite and weight
.Abnormal hair distribution '
.Nervousness
.