One important component of a comprehensive physical exam is the neurologic examination. The NeuroExam app is designed to assist with the assessments. Designed by a team of physical therapists with backgrounds in neurology, sports, and orthopedics, NeuroExam is geared toward anyone who may conduct a neurologic examination, but appears primarily focused on physical therapists. Physicians, (both allopathic and osteopathic), therapists, and students in training for these fields of medicine may benefit from this app. Specifically, those working closely with physical therapists (traditionally Neurologists, Orthopedists, and Physical Medicine & Rehabilitation physicians) may find NeuroExam most helpful.
NeuroExam is available for iOS devices only at this time, iPad or iPhone. iOS 9.0 or later is required, and with the included videos it takes up a little over 1gb of space.
The NeuroExam app has a polished and user friendly interface, showcasing various topics to choose from once the app is opened. Topics are as follows: Motor Control, Sensation, Tone, Reflexes, Coordination, Balance, Gait Measures, and Diagnosis Specific (Stroke, Spinal Cord Injury, etc). Each topic offers assessments and tests relevant to the subject, with additional more specialized evaluations to refer to. Set up and equipment details, patient and therapist positions are also made available along with cues, grade scoring, and normative value interpretations. There is also a high-quality video of a therapist performing the activity in question on a practice patient. Videos are very well done, with excellent audio quality, and clear cut instructions on the maneuver. The developers have clearly invested significant time in creating the app, as the many videos and various topics included within detail.
Medical students are often taught a basic neurologic examination, consisting of cranial nerves, strength, sensation, proprioception, mental status, and reflexes, in a very step-wise, systematic manner. While somewhat rigid, this approach does help reinforce the basic principles of a very valuable component of the physical exam, and is not what NeuroExam offers. Perhaps most useful for medical students and other clinicians looking for general neurological exam assistance is the Cranial Nerve Exam segment, located under the Diagnosis Specific section, with excellent videos for CN I-XII. Otherwise, much of the layout of the app, while excellent for what it offers, is not geared towards learning a general neurological exam. Instead, the focus is on fairly specific maneuvers for various topics.
Several of the measures utilized and taught throughout the app may be unfamiliar to those out of rehabilitative fields. These include the Modified Ashworth Scale for spasticity rating, Timed Up and Go, American Spinal Injury Association (ASIA) impairment scale, Fugl-Meyer, amongst others, and are more specialty-dependant measurements. As a physiatrist, it’s fantastic to see these included within the app, as we often utilize such tools in patient management. The app even walks the user through an entire ASIA exam, a fairly lengthy process, with a video for each portion of the test.
Evidence Behind the App
Each test listed in NeuroExam includes a section of References behind the test. These predominately appear to be from several therapy sources, both primary and journals, and some from presentations at various conferences. It would have been nice to see references on the origin of the examination, relative sensitivities and specificities, etc, for each maneuver included.
- Excellent collection of specialized Neurologic exam tools
- High-quality videos
- Easy to navigate, excellent user interface
- Would love to see a head-to-toe standard Neurologic assessment feature
- Original exam references may be helpful
PhysioU: NeuroExam is a comprehensive app for a large number of specific maneuvers utilized by physical therapists and others involved in rehabilitative care. It’s not an app that I would recommend to medical students for learning a basic neurologic exam, however it is an excellent app for learning a variety of exams common to PM&R and Neurology, amongst others. The excellent production quality of the app and the wealth of information within are a testament to the developers’ dedication to providing a high-quality, educational experience for users. After becoming comfortable with a basic neurologic exam, medical students and physicians in training may consider trying out NeuroExam to further familiarize themselves with more involved measurement tools and exams important in the field.
- Overall Score
- User Interface
Excellent layout, easy to navigate and become comfortable with from the start
- Multimedia Usage
Fantastic videos, sharp and crisp, along with a solid graphical design utilized throughout
$6.99 through iTunes, but it offers a large library of content in return for the purchase
- Real World Applicability
While primarily for physical therapists, this is still an excellent tool for learning various neurologic examination skills, and becoming familiar with certain neurologic assessment scales.
- Available for DownloadiPhoneiPad