Beruflich Dokumente
Kultur Dokumente
§
-Designed By-
Dr. Krishna N. Sharma
§
-Publication-
Online Physio Community, India
Web: http://www.opcindia.info.ms
E-Mail: dr.krisharma@gmail.com
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Orthopaedic Assessment
Name :
Age : Gender: Occupation:
Address:
Chief Complaints:
Present History:
Mode of Onset:
Duration:
Associated Problem:
Personal History:
Personal Habits:
Marital Status:
Family History:
Similar Problem in relatives:
Hereditary Diseases:
Consanguinity:
Infections:
Economical History:
Income: Expenditure:
Source:
Social History:
Social Status:
Educational Status:
Environmental History:
Environment of Home:
Environment of Workplace:
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Vital Signs:
Heart Rate: Temperature:
Blood Pressure: Respiratory Rate:
General Observation:
Built: o Lordotic Gait:
Posture: o Scissoring Gait:
Gait: o Talus Gait:
o Antalgic Gait: o Trendlenburg Gait:
o Ataxic Gait: o Valgus Gait:
o Calcaneal Gait: o Varus Gait:
o Circumductory Gait: o Waddling Gait:
o Hand to Knee Gait: o Other:
o High Stepping Gait: Deformities:
o Jack Knifing Gait:
Local Observation:
Inflammation: Skin Condition:
Swelling: Muscle Wasting:
Scar: Shape Alteration:
Palpation:
Swelling: Pitting, Non-Pitting
Tenderness: GradeⅠ/ Grade Ⅱ/ Grade Ⅲ/ Grade Ⅳ
Warmth:
Crepitus:
Scar: Heal / Non-Heal / Length
Sensory Examination:
Superficial Sensations:
o Pain:
Nature:
Mode of Onset:
Course (If Radiates):
Aggravating Factors:
Relieving Factors:
Visual Analogue Scale:
0 1 2 3 4 5 6 7 8 9 10
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o Touch: Normal, Anesthesia, Hyperesthesia, Hypoesthesia
o Temperature:
Hot Test Tube (40-45∘C):
Cold Test Tube (5-10∘C):
Deep Sensations:
o Propioception: o Vibrations:
o Kinesthesia:
Cortical Sensations:
o Graphesthesia: o Tactile Localization:
o Stereognosis: o 2 Point Discrimination:
Superficial Reflexes:
o Corneal Reflexes:
o Abdominal Reflexes:
Epigastric Region (T7-T9):
Upper Abdominals (T9-T11):
Lower Abdominals (T11-T12):
o Cremastric Reflex (L1-L2):
o Anal Reflex (S4-S5):
o Planter Reflex:
Range of Motion:
Joint Rt.(Active) Lt.(Active) Rt.(Passive) Lt.(Passive) End Feel Pain
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Muscle Power:
Muscle Rt. Lt.
Limb Length:
Rt. Lt.
True
Apparent
Pelvic Square:
Segmental Limb Length:
Rt. Lt.
Humeral
Ulnar
Femoral
Tibial
Muscle Girth:
Rt. Lt.
Arm
Forearm
Quadriceps
Calf
Balance: 0 – Unable to do
Static: 1 – With Human Support
o Sitting (With eyes open & closed) 2 – Using Aid
o Standing (With eyes open & closed) 3 – Needs Supervision
o Tendem Standing (With eyes open & 4 - Independent
closed)
Dynamic:
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o Reaching out activities: Able/Unable
o Perturbation: Able/Unable
Gait Analysis:
Stance Phage: Base Width:
Swing Phage: Cadence:
Step Length: Other:
Stride Length:
Radiological Findings:
Special Tests:
Differential Diagnosis:
Diagnosis:
Physiotherapy Aims:
To relieve pain
To increase ROM
To correct the deformity
To relieve stiffness
To improve muscle power & strength
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To improve muscle endurance
To maintain tissue extensibility
To correct posture
To improve balance
To train for walking aids
Gait training
Other
Physiotherapy Plan:
Ergonomics:
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