Solve Physiotherapy Assessment
Posture
BMI:
Gait
Swing Phase
Stance Phase
Squat
Bilateral
↓ Hip hinge
↓ Ankle ROM
Pelvic Rotation
Notes:
Single Leg (Mod Pistol)
Left
Right
↓ Hip hinge
Lateral Sway
Pelvic Rotation
Balance (SLS)
L SLS
R SLS
L SLS + Head
R SLS + Head
Notes:
Lumbar AROM
Flexion
Extension
Side Flexion L
Side Flexion R
Shoulder
HBB L
HBB R
HBH L
HBH R
FLEX
L
R
ABD
L
R
ER
L
R
Scap AROM
Left
Right
Alignment
Breathing
THORACIC ROTATION - ROM
UPPER ROTATION
L
R
LOWER ROTATION
L
R
Compensations:
LATERAL DERMAL RESTRICTION
BREATHING PALPATION
Decreased Posterior Costal Expansion:
Costal Expansion
cm
Strength
Rotation
L
R
Deadbug (1→2)
Quality
AROM
AROM:
FLEXION
°
EXTENSION
°
LR
°
RR
°
LSF
°
RSF
°
PROM
LR
°
RR
°
Sub-occipital Flexion
Palpation
Suboccipitals
Pain
Tone
Dermal Rest.
Mid-Section
Pain
Tone
Dermal Rest.
CT Junction
Pain
Tone
Dermal Rest.
Palpation Notes:
Joint Stiffness
+ = decreased PIVMS
CTJ Extension
L
R
Upper Cervical
L
R
Joint Stiffness Notes:
Lats Length
Left
Right
Myotomes
TestedPositive
Left
C4:
C5:
C6:
C7:
C8:
T1:
Right
C4:
C5:
C6:
C7:
C8:
T1:
Neural
TestedPositive
Angle from vertical
Left
Median:
°
Ulnar:
°
Radial:
°
Right
Median:
°
Ulnar:
°
Radial:
°
Palpation
Reflexes
TestedPositive
Left
Biceps:
Brachio:
Triceps:
Right
Biceps:
Brachio:
Triceps:
Special Tests
Myotomes
TestedPositive
Left
L2:
L3:
L4:
L5:
S1:
Right
L2:
L3:
L4:
L5:
S1:
Neural
TestedPositive
Left
Sciatic:
Femoral:
Saphenous:
Right
Sciatic:
Femoral:
Saphenous:
SLR
Left
°
Right
°
Neural Palpation
Reflexes
TestedPositive
Left
Patellar:
Achilles:
Right
Patellar:
Achilles:
Sensation
Notes:
Lumbar Palpation
2 Finger Test L
2 Finger Test R
Special Tests
+ = positive test
Buttock Squeeze:
SIJ
AROM
Left
Right
FLEX
°
°
ABD
°
°
ER
°
°
ER @ 90
°
°
IR @ 90
°
°
PROM
Left
Right
FLEX
°
°
ABD
°
°
ER
°
°
ER @ 90
°
°
IR @ 90
°
°
STRENGTH
Left
Right
FLEX
ABD
ER
IR
ER @ 90
IR @ 90
JOINT POSITION
ER 90/90
Left
Right
IR 90/90
Left
Right
Laxity
Left
Right
PALPATION
Notes:
SPECIAL TESTS
Notes:
NOTES
Notes:
OBSERVATION
Notes:
AROM
Upward Rotation
Left
Right
PROM
Upward Rotation
Left
Right
Protraction
Left
Right
STRENGTH
UFT (Upper Fibers Trapezius)
Left
Right
MFT (Middle Fibers Trapezius)
Left
Right
LFT (Lower Fibers Trapezius)
Left
Right
SERATUS
Bilateral Scap Push-Up
Left
Right
Single Arm Plank
Left
Right
PALPATION
Notes:
PROM
Left
Right
FLEX
°
°
ABD
°
°
IR
°
°
ER
°
°
EXT
Left
Right
STRENGTH
Left
Right
FLEX
ABD
ADD
ER
IR
HIP EXTENSION PCR
HIP EXTENSION
Left
Right
PALPATION
Notes:
SPECIAL TESTS
Notes:
OBS
Notes:
PROM
Left
Right
FLEX
°
°
EXT
°
°
ROM Notes:
PALPATION
TestedPositive
Left
Right
Retropatellar
Medial
Lateral
Palpation Notes:
LIGAMENTS
ACL
Left
Right
MCL
Left
Right
LCL
Left
Right
PCL
Left
Right
MENISCUS
Left
McMurrays:
Right
McMurrays:
NOTES
Notes:
OBSERVATION
Notes:
PROM
Left
Right
DF
°
°
Great Toe EXT
°
°
STRENGTH
Left
Right
PF - Knee Ext
PF - Knee Flex
Great Toe
JOINT
Mid Foot Play
Left
Right
PALPATION
Notes:
SPECIAL TESTS
Notes:
Tissue Diagnosis
Hypothesis
Intervention
Changes Seen Post Intervention
Changes seen post intervention:
Take Home
Next Session
Treatment Plan
Sessions:
Sessions:
Sessions:
Total: 0 sessions overweeks