Rehabilitation and chiropractic practice.

In summary, evaluation attempts to identify mechanical sensitivities and muscle or joint dysfunctions that are responsible for a patient's inability to achieve a demand minimum functional capacity. Basic skills that patients use in their jobs, sports or activities of daily living are evaluated (DOT) to establish those minimum demands for return to work. Typically, examination proceeds from active to passive tests. Inspection of posture, range of motion and basic skills (DOT) may come first. This can be followed by active provocative maneuvers such as McKenzie or orthopedic testing (i.e., Kemps). Muscle strength, coordination or endurance tests would then come. These are followed by passive tests of joint play and muscle length. Finally, passive provocative maneuvers, such as orthopedic tests (i.e., Gaenslen's) or soft tissue palpation (i.e., trigger points), would occur last. The goal of evaluation is to achieve diagnostic triage, monitor outcomes, find key functional pathologies and identify work capacity. All these goals should be met by a chiropractic rehabilitation specialist.