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Physio Review
Patient Assessment - Page 1 (Edit)
Date *
Patient Name *
PR No
Age / Gender *
F
M
T
Contact No
Reference
Address
15E2E2 road, Thendral nsgar narimedu
Occupation Type *
Select
Government
Non-Government
Senior Citizen
Others
Designation
Nature of Work
Select
Active
Desktop
Field
Travel
House Holder
others
Vitals
HEIGHT
WEIGHT
BP
PR
TEMP
SPO2
Other Health Issues & Treatment History
-
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History of Present Complaints
1 and half years - Right side neck pain - Sudden onset during a neck turning movement 1 year - right shoulder pain - sudden onset after a fall during fielding in cricket Able to play cricket with mild negotiable pain
Onset
Sudden
Insidious
Gradual
Treatment Taken
Neck pain - Apollo hospitals Shoulder pain - Ortho and 2 physios - Discontinued Physio treatment due to not satisfaction
Investigation Details
Not Taken
Done , Not Produced
Attached with Case Sheet
Current Physiotherapy Episode
1
2
>3
Previous Session Details
Wax bath - Myofascial release - Cupping for neck and shoulder - Stretches passive - IFT - SWD Vetri Physiotherapy
Update
Present Complaints
Neck - Knuckles and sound while moving the neck - Tendency to knuckle after a brief period of sitting. Shoulder - Pain while sleeping - Difficulty and pain in throwing - Using underarm throwing - Wakeup pain - Habit of sleeping in arm
Symptoms
Constant
Intermittent
Worsening Factors
Relieving Factors
Pain Chart Notes
4 - 25-27
Pain Scale
Worst
Same
Better
VAS
At Worst
At Best
Pain Type
Nociceptive
Neuropathic
Nociplastic
Skin Colour
Scar
Adherent
Non-Adherent
No Scar
Swelling
Soft Fluctuating
Leathery
Tough
Dry
Tened
Hard
Boggy
Spongy
Thick
8 to 24 Hours of Injury
Tenderness
Grade I
Grade II
Grade III
Grade IV
Remarks
Neck right side
Update
Edit - Page 3
Dashboard
Patient Management
Edit - Page 3
ROM
AROM
Movement
Side
Part
Plane
Available Range
Pain Starts
Action
Select
Left
Right
Select
Neck
Wrist
Shoulder
Elbow
Spine
Hip
Knee
Ankle
Select
Sagittal
Frontal
Transverse
-
+ Add AROM
PROM
Movement
Side
Part
Plane
Available Range
Pain Starts
Action
Select
Left
Right
Select
Neck
Wrist
Shoulder
Elbow
Spine
Hip
Knee
Ankle
Select
Sagittal
Frontal
Transverse
-
+ Add PROM
End Feel
Soft
Firm
Hard
Empty
MMT
-
+ Add MMT
Special Tests
Special Test 1
Special Test 2
Remarks
C spine instability Right supraspinatus chronic strain FOCUS: C spine stability Rotator cuff stability and progress to power builtup Patient needs to pain free play
Diagnosis
Patient Goals & Concerns
Physiotherapy Goals
Short Term Goals
Long Term Goals
Action
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Further Referral (if needed)
Physiotherapist Details
Assessed Physio Name
IAP Membership No.
Treatment In-Charge Name
IAP Membership No.
Update
Electrotherapy
Modality
Site
Details
Date
Remarks
Action
-
-
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Supportive Techniques
Technique
Details
Date
Remarks
Action
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Corrective Exercises
S.No
Exercise
Sets
Reps
Time
Date
Remarks
Action
1
-
2
-
3
-
4
-
+ Add Row
Date
Remarks
6 sessions rPMS x 2 weeks followed by 2 sessions per week x 3 weeks Total 12sessions in 5 weeks Fee Rs.1200 for rPMS sessions Fee Rs.800 for Non-PMS sessions
Update
