Evaluacin kinsica.

Nombre:

Edad:

Rut:

Direccin:

Ocupacin:

Con quien vive:

Cuidador:

Grupo familiar:

Redes de apoyo:

Nivel educacional:

Derivado de:

Dg medico (cuanto tiempo):

Observacin ___________________________________________________________
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Entrevista

Anamnesis actual ___________________________________________________

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Anamnesis remota __________________________________________________
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Estado de conciencia __________________________________________________
Orientacin (OTE) _____________________________________________________

Inspeccin

Coloracin ______________________________________________________
Alteraciones en piel y vasculares ____________________________________
Patrn respiratorio _______________________________________________
Trofismo ________________________________________________________
Ulceras _________________________________________________________
Postura corporal __________________________________________________
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Transferencias ___________________________________________________
Marcha _________________________________________________________

Palpacin

Textura (humedad y elasticidad) _______________________________________

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Tono ____________________________________________________________
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Temperatura ______________________________________________________
Compensaciones musculares _________________________________________
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Trofismo _________________________________________________________
Deformidades ______________________________________________________
Puntos dolorosos: ___________________________________________________

Movilizacin Pasiva

ROM _____________________________________________________________
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Tono muscular ____________________________________________________
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End feel__________________________________________________________
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Lesin perifrica ________________________________________________________

Lesin central _________________________________________________________
Escala de asworth _____________________________________________________
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Movilidad Activa

ROM _____________________________________________________________
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Tono muscular ____________________________________________________
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Observaciones: ______________________________________________
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Sensibilidad

Superficial
Tacto __________________________________________________________________
Dolor __________________________________________________________________
Temperatura ____________________________________________________________

Profundo
Cinestesia _____________________________________________________________
Palestesia _____________________________________________________________
Barestesia _____________________________________________________________
Esterognosia _____________________________________________________________
Grafoestesia _____________________________________________________________
Batiestesia _____________________________________________________________

Reflejo

Osteotendinosos ____________________________________________________
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 Cutneos __________________________________________________________
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Reacciones automticas _____________________________________________

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Coordinacin ___________________________________________________________
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Equilibrio

Esttico _________________________________________________________
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Dinmico ________________________________________________________
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Marcha _____________________________________________________________
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Pruebas funcionales__________________________________________________
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Hallazgos _______________________________________________________________
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Diagnstico mdico _____________________________________________________

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Diagnstico kinsico _____________________________________________________

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Objetivo general _____________________________________________________

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Objetivos especficos Tratamiento