SILVER OAK UNIVERSITY

College of Physiotherapy
Bachelor of Physiotherapy
Course Name: Physical & Functional Diagnosis
Course Code: 1140333305
Year: 3rd

Prerequisite:

Anatomy, Biomechanics, Kinesiology, Basics of Exercise Therapy I and II

Course Objectives:

1. Equip students with the skills to perform comprehensive physical assessments and
functional evaluations.
2. Enhance their ability to identify and diagnose musculoskeletal, neurological, and
cardiopulmonary conditions.
3. Train students in the use of diagnostic tools and techniques to assess patient mobility,
strength, and functional abilities.
4. Foster critical thinking and clinical reasoning to develop effective treatment plans based on
diagnostic findings.

Teaching Scheme:

Duration Teaching Scheme

L T P Contact Hours Credit
Per Term 3 0 3 6 4.5
Per Year 3 0 3 6 9
1 credit = 1 classroom lecture per week for 1 term or 2 Practical/clinical hours per week for 1
term.

Contents:

Teaching
Unit Topics % Weightage
Hours
General principles of Human Development & Maturation
aspects
Physical Motor, Sensory, Cognitive, Cultural, Social, Emotional.
Factors influencing Human Development & Growth:
Biological, Environmental, Inherited.
Principles of Maturation: In general - anatomical directional
pattern cephalo – caudal proximo – distal centero –lateral. Mass
1
to specific pattern. Gross to fine motor development. 17 15
Reflex maturation tests.
Development in specific fields: Oromotor development,
Sensory development, Neurodevelopment of hand function
Conditional & Control Structures:
Electro Diagnosis
Bioelectricity: Physiology of generation & propagation of
2 17 15
Action Potential, Volume Conduction.
Therapeutic current-as a tool for electro diagnosis.
 Physiological principles, use of alternating & direct currents in
electro-diagnosis such as sensory & Pain threshold, Pain
tolerance, -Short & long pulse test, S.D. curves, Chronaxie &
Rheobase, accommodation ratio.
Principles of nerve conduction studies, late responses.
E.M.G. instrumentation, basic components, panel diagram, types
of electrodes.
Principles of Electro-myography
motor unit –Normal characteristics-activity at rest,
recruitment/frequency pattern at minimal activity, Interference
pattern.
Assessment of Neurological Dysfunction
Higher functions, cranial nerves, sensations & sensory
organization, body image, tone, reflexes: superficial & deep,
voluntary control, muscle strength, coordination, balance,
posture, gait.
3 22 19
Scales: FRT, Berg’s Balance, modified Ashworth, Glasgow
Coma, TUG, FIM
Functional diagnosis using ICF.
Interpretation of electro diagnostic findings, routine biochemical
investigations.
Assessment of Musculoskeletal Dysfunction
Tightness, deformity, joint mobility, muscle strength, limb
length, trick movement, girth, posture, gait, special tests.
Functional diagnosis using ICF.
Interpretation of X-ray of extremities & spine, routine bio-
4 chemical investigations, CT scan, MRI. 22 19
Assessment of pelvic floor muscle strength and function: i.
Digital evaluation of vagina ii. Perineometer iii. Pad test
Disability Evaluation: Gait and Gait parameters, percentage of
Disability (temporary and permanent) Scales - NDI, MODI,
WOMAC, SPADI, UEFS, LEFS.
Assessment of Cardio -Pulmonary dysfunction
Vital parameters, chest expansion, chest excursion, breath
holding test, breath sounds, rate of perceived exertion (RPE),
peak flow rate.
Exercise Tolerance:

5 six minutes’ walk test, shuttle test, theoretical bases of Bruce’s 22 19

protocol, step test.
Ankle Brachial Index, tests for peripheral arterial & venous
circulation
Functional diagnosis using ICF
Interpretation of X-ray chest, routine biochemical investigations,
ABG, PFT, ECG (normal values).
Assessment
Pain: Intensity & quality
Objective assessment & documentation: VAS, Numerical Rating
Scale. Other scales.
Obesity: Classification Assessment – BMI, Waist
6 14 13
circumference, Waist – Hip ratio
Introduction to Quality-of-Life Questionnaire.
Hand: Sensations, Mobility of joints, strength Special tests.
Hand function: Precision & power grips.
Wound:Evaluation of area of the wound, Wound Healing
Course Outcomes:

Sr. No. CO Statement Unit

CO-1 Describe principles and factors of human development and maturation 1

Apply and analyze electro-diagnostic techniques and principles of electro-
CO-2 2
myography.
CO-3 Evaluate neurological dysfunctions using assessment tools and ICF framework 3
Analyze and evaluate musculoskeletal dysfunctions using assessment tools and
CO-4 4
ICF framework
Conduct cardio-pulmonary, Obesity and pain assessments using objective
CO-5 5,6
measures and interpret findings

Teaching & Learning Methodology:

1. Lectures
2. Presentations
3. Group Discussions
4. Demonstrations
5. Small Group Activities
6. Problem-Based Learning (PBL)
7. Simulated Case Based Scenarios

List of Experiments: 114 Hours

Sr. No. Practical
Perform nerve conduction studies on common peripheral nerves, measuring conduction
velocity and amplitude. Identify and interpret late responses such as F-waves and H-
reflexes.
1. Use surface electrodes to record muscle activity at rest and during contraction. Analyze
EMG waveforms for signs of muscle and nerve health.
Conduct experiments to measure chronaxie and rheobase for specific nerves or muscles.
Explore how these parameters reflect nerve and muscle health.
Conduct a mini-mental state examination (MMSE) or Montreal Cognitive Assessment
(MoCA) to evaluate cognitive function
Test each of the 12 cranial nerves to assess their function and identify any abnormalities.
Use tools like tuning forks, monofilaments, or pinpricks to assess different sensory
modalities such as touch, pain, temperature, and vibration.
Muscle Tone Assessment
Use the modified Ashworth scale to evaluate muscle tone and spasticity.
2. Reflex Testing
Test superficial (e.g., abdominal, plantar) and deep reflexes (e.g., knee jerk, biceps reflex).
Voluntary Control and Muscle Strength: Voluntary control gradings
Perform manual muscle testing (MMT) to assess muscle strength.
Coordination Testing
Conduct coordination tests like finger-to-nose, rapid alternating movements, or heel-to-
shin, Romberg’s Test
Balance and Posture Assessment
 Use the Berg Balance Scale and Functional Reach Test (FRT) to assess balance and use
grid tests and observational analysis for posture.
Assessment of Muscle Tightness
Use stretching tests to assess muscle tightness and flexibility.
Joint Mobility Testing
Perform goniometry to assess joint range of motion.
Limb Length Measurement
Use a measure tape or other techniques to assess limb length discrepancies.
Trick Movement Detection
Observe for compensatory movements during specific tasks.
Muscle Strength Assessment
Perform manual muscle testing to assess strength and endurance.
Posture Analysis
Evaluate posture in various positions (e.g., standing, sitting) to identify deformities or
3.
imbalances.
Gait Analysis
Conduct gait analysis to evaluate walking patterns and identify potential issues.
Special Tests
Test of Cervical, Shoulder, Elbow, Wrist, Thoracic, Lumbar, Pelvic, Hip, Knee and Ankle
Joint.
Pelvic Floor Muscle Strength and Function
Conduct digital evaluations, use a perineometer, and perform the pad test to assess pelvic
floor strength.
Disability Evaluation
Assess gait and other parameters to evaluate the percentage of disability, including
temporary and permanent conditions.
Assessment of Vital Parameters
Measure blood pressure, heart rate, respiratory rate, and oxygen saturation (SpO2).
Chest Expansion and Excursion Test:
Measure chest expansion with a measuring tape at specific levels (e.g., axillary, nipple,
and subxiphoid) during inspiration and expiration.
Breath Holding Test
Determine the maximum breath-holding capacity, which can indicate respiratory function
and lung capacity.
Breath Sounds, Rate of Perceived Exertion, Peak Flow Rate
Breath Sound Assessment
Use a stethoscope to auscultate breath sounds in different lung regions, listening for
4.
abnormal sounds like crackles, wheezes, or rhonchi.
Rate of Perceived Exertion (RPE)
Have subjects rate their exertion level using the Borg RPE scale during physical activity
or exercise.
Peak Flow Rate Measurement
Use a peak flow meter to measure peak expiratory flow rate, assessing lung function and
monitoring conditions like asthma.
Exercise Tolerance Tests
Six-Minute Walk Test (6MWT):
Shuttle Test:
Bruce Protocol for Exercise Tolerance:
 Step Test:
Ankle Brachial Index and Tests for Peripheral Circulation
Ankle Brachial Index (ABI) Measurement:
Tests for Peripheral Arterial and Venous Circulation:
Functional Diagnosis Using ICF
Use the International Classification of Functioning, Disability, and Health (ICF)
framework to assess functional limitations and contextual factors in cardio-pulmonary
conditions.
Interpretation of Chest X-rays
Routine Biochemical Investigations and ABG Analysis:
Pulmonary Function Test (PFT) Interpretation:
Interpret PFT results, including forced vital capacity (FVC), forced expiratory volume in
one second (FEV1), and other parameters to assess lung function.
Electrocardiogram (ECG) Interpretation
Analyze ECG readings to identify normal values and detect arrhythmias, ischemia, or
other heart conditions.
Pain Intensity & Quality Assessment
Use the Visual Analog Scale (VAS) and the Numerical Rating Scale (NRS) to evaluate
pain intensity.
Document pain quality using descriptive words and scales such as the McGill Pain
Questionnaire.
Objective Assessment and Documentation:
Practice using VAS and NRS to objectively assess pain in a peer/model.
Document pain assessments in a standardized format for easy reference and comparison
over time.
Assessment of Hand
Sensations Testing:
Use monofilaments or two-point discrimination tests to evaluate hand sensations.
Mobility of Joints & Strength:
Perform joint range-of-motion tests and grip strength measurements using a dynamometer.
Special Tests for Hand:
Conduct special tests like Tinel's and Phalen's to assess conditions such as carpal tunnel
5.
syndrome.
Hand Function Assessment:
Evaluate precision and power grips through tasks like grasping and pinching.
Use specific tests or activities to measure hand function and dexterity.
Assessment of Obesity
Obesity Classification and Assessment:
Calculate Body Mass Index (BMI) for classification of obesity.
Measure waist circumference and waist-to-hip ratio to assess obesity-related risks.
Waist Circumference and Waist-Hip Ratio:
Use a measuring tape to accurately measure waist circumference and waist-to-hip ratio on
a peer/model.
Quality of Life and Wound Assessment
Quality of Life Questionnaire:
Introduce and administer a quality-of-life questionnaire to assess the impact of conditions
on overall well-being.
Wound Assessment
 Practice wound assessment, including size, depth, exudate, and signs of infection.
Learn to document wound healing progress and evaluate the effectiveness of wound care
interventions

Major Equipment:

1. EMG – NCV Machine

2. Vestibular Ball
3. CPR mannequin

Books Recommended:

1. Mage D. "Clinical Orthopedic Assessment." Elsevier Publications.

2. Misra UK. "Clinical Neurophysiology." Elsevier Publications.
3. O'Sullivan SB. "Physical Rehabilitation."
4. Frownfelter D, Dean E. "Cardiovascular and Pulmonary Physical Therapy: Evidence to
Practice." Mosby Publication.
5. Norkin CC. "Measurements of Joint Motion." Jaypee Publications.
6. Gerard JA. "Orthopedic Testing." Churchill Livingstone.
7. Pryor J. "Physiotherapy for Respiratory and Cardiac Problems." Elsevier Publications.
8. American Physical Therapy Association. "Guide to Physical Therapy Practice: Revised."
Alexandria, VA: American Physical Therapy Association.

List of Open-Source Software/learning website:

● http://silveroakuni.ac.in/video-lecture
● https://www.physio-pedia.com/home/

CO-PO-PSO Matrix:

Co. No. PO1 PO2 PO3 PO4 PO5 PO6 PO7 PO8 PO9 PO10 PSO1 PSO2

CO-1 3 1 1 1 1 - - 1 1 - 1 2
CO-2 2 3 2 3 2 2 1 1 1 - 1 1
CO-3 2 3 3 3 3 2 1 1 1 - 1 2
CO-4 2 3 3 2 3 2 2 1 2 1 1 1

CO-5 2 3 3 3 3 2 1 1 1 1 1 1