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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
Gayathri Nagar
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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-
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History of Present Complaints
Right side rotator cuff tear with OA shoulder Left Partial rotator cuff tendonitis
Onset
Sudden
Insidious
Gradual
Treatment Taken
7th May,2026 - Right shoulder Reverse shoulder arthroplasty Left shoulder - Intraarticular shoulder injection
Investigation Details
Not Taken
Done , Not Produced
Attached with Case Sheet
Current Physiotherapy Episode
1
2
>3
Previous Session Details
Home visit - Dr Hamsa, PT - Shanthi Priya clinic - weekly5 sessions x 2 months + 13 sessions in last month Discontinue the treatment for further studies
Update
Present Complaints
Right shoulder - Pain settled - Difficulty in lifting the shoulder Left shoulder - Pain settled to some extent, but not completely - Most of the activities are doing with the left hand
Symptoms
Constant
Intermittent
Worsening Factors
Relieving Factors
Pain Chart Notes
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
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
-
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
-
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
Patient movement limitation is mainly due to weakness - Poor rehab FOCUS: ROM exercises as warm-up - Isometrics - Resistance training to the available range - Improve Muscular endurance Use Re-education board elimination or against gravity Inform the patient to do warmup till the arrival of Physio
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
-
+ Add Row
Date
Remarks
3 days per week x 6 months - Followed by 2 or 3 days per week for 2 weeks Fee Rs.800
Update