Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Physical Therapy for Shoulder Joint I. BASIC DATA: Chart number: _______ Name:_______ Age:_____ Gender: ○M ○F DATE:_____/_____/_____ Body weight: ____Kg; Body Height: ____cm; Date of PT starting: _____/_____/____ Impression: Involved shoulder: □ right □ left Dominant shoulder: □ right □ left Work status: □ Not working □ Working Brief history: (Onset, causes, duration, pain status, affecting factors, and previous history should be included.) night pain: □ yes □ no; Visual analog scale: Does pain increase in the previous one month □ yes □ no Frequency: □ pain all the time □ per day □ per week II. PHYSICAL EXAMINATION: 1. Observation: Shoulder Posterior view □Both sides are horizontal □Elevated/depressed Shoulder Lateral view □Plumb bisects acromion □Tilt □Forward (round shoulder) Scapula Posterior view □Medial borders are □Adducted / Abducted parallel, about 2” from the spine □Downward / Upward rot □Elevated / Depressed Scapula Lateral view □Scapula held flat against □Winged the thorax, 30° anterior to □Tipped Anteriorly frontal plane Humerus posterior view □Olecranon processes face posteriorly □Internally/Externally rotated Humerus lateral view □Distal humerus vertically □Distal humerus anterior/ in line with the proximal humerus posterior to the proximal 2. Palpation: Muscle origin and insertion as well as bursa; tenderness to palpation in the region of the greater tuberosity, acromion, or rotator cuff tendons 3. Selective tissue tension test Active: Pain1;Willingness1 Flexion Abduction Internal rotation External rotation 1 +: positive; -:negative . Range: initial, mid, end 3 Hard, firm, soft, empty 4 Strong, weak 2 Passive: Resisted: Pain1,2; Endfeel3 Pain1; Strength4 4. Range of motion Left arm Movement Right arm Flexion Extension Abduction Internal rotation arm by side External rotation arm by side Internal rotation 90 degrees abd External rotation 90 degrees abd Anterior shoulder tightness5 Posterior shoulder tightness5 5. Joint play: Anterior-posterior6 Superior-inferior6 Glenohumeral joint: Scapulothoracic joint: Acromioclavicular Joint: 6. Movement analysis scapulo-humeral rhythm Rhythm7 Arm ascending Arm descending 5 6 7 8 Additional information Hyper or hypo mobility Normal or abnormal +:positive ot -:negative Pain8 7. Muscle dysfunction test9 Strength9 Tightness9 Pectoralis minor Levator scapulae Rhomboids Trapezius Upper Trapezius Middle Trapezius Lower Serratus anterior Pectoralis major Latissimus dorsi Coracobrachialis Biceps Triceps Pectoralis major (upper, lower) Teres major Supraspinatus and middle deltoid Infraspinatus Teres minor Subscapularis Deltoid anterior Deltoid posterior 9. Functional activity Performance-based tests10 HAND-IN-NECK; HAND-TO-SCAPULA; HAND-TO-OPPOSITE SCAPULA MODIFIED KIBLER’S LATERAL SCAPULAR SLIDE TEST Self-reported test: DASH11 and FLEX-SF12 Functional self efficacy13 Option: 9 Selected muscles as appropriate; +:positive (strong or tight); -:negative (weak or no tight); ne: not examination; na: not available 10 See additional information for scoring 11 DASH: Disabilities of the Arm, Shoulder and Hand; http://www.dash.iwh.on.ca/ 12 FLEX-SF: Flexilevel score of shoulder function; Cook, K.F., Roddy, T.S., Gartsman, G.M., Olson, S.L. Development and psychometric evaluation of the Flexilevel Scale of Shoulder Function. Med. Care. 200341, 823-835. 13 Functional self efficacy: Maly MR, Costigan PA, Olney SJ. Determinants of self efficacy for physical tasks in people with knee osteoarthritis. Arthritis Rheum. 2006 15;55:94-101. Shoulder Pain and Disability Index Simple Shoulder Test American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form Quality of life 10. Special test □ Impingment test □ Neer impingement test, □ Hawkins impingement test □ painful arc of movement (60°–120°) □ Add tests as necessary III. ASSESSMENT: (Problems and reasons should be added.) IV. PT PROGRAMS: V. HOME PROGRAMS: