Evaluation - Therapeutic section 1

Evaluation sheet:
1. Personal data:
a. Name
b. Age
c. Address
d. Occupation
e. Athlete/ non-athlete
2. Chief complaint: As patient describes e.g. Inability or heaviness in moving extremity (from hemiplegia), numbness and weakness in arm (from cervical spondylosis)
3. Present history of condition:
- Onset (Acute/ Gradual)
- Course (Progressive/ regressive)
- Duration
4. Past history of injury, disease or surgery related to the condition
5. Family history of common congenital diseases e.g. hypertension, heart disease

Evaluation:
1. Observation: patient's gait, sitting posture
2. Palpation: feel for hotness, redness, edema, contracture, etc. Always compare with other side.
3. Medical report: X-ray, complete blood picture, physician report, etc.
4. Long and round measurements
5. ROM and Muscle test
6. ADL functional assessment
7. Balance test e.g. ataxia affecting cerebellum disturbs coordination
8. Sensation tests: Impaired sensation from spondylosis or diabetes
9. Posture assessment: e.g. checking for spinal deviation by hyperemial test, X-ray
- Observation: checking for deformities from anterior, posterior and lateral views. Use plumb line on C7, square chart and moiré topography.

*Posture: Position assumed by body parts
Good posture: Position assumed by body parts to maintain balance and stability with minimum energy and minimum strain
Benefits:
- Keeps ms relaxed
- Increase cardiac and respiratory efficiency
- Prevent associated 2ry problems with deformity
- Improve mental and psychological state e.g. forward head can cause headache

Poor posture: Any deviation from the erect upright ideal posture.
Causes:
 Bone shortening.
 Ms shortening, weakness or paralysis.
 Jt stiffness, pain or edema.
 Defective hearing or sight.
 Bad habits.
 Pain (ms guarding).
 Fatigue
Complications:
1- Ms strain
2- Reduced cardiac and respiratory efficiency
3- 2ry problems to deformity
4- Affects mental/ psychological state

Advice for good posture:
• Don't remain in one position for a long time e.g. if standing for a long time then rest one leg on a step to relax illiopsoas thus reducing LBP.
• Sleep on a hard mattress
• Use one pillow only
• Put a small cushion below low back to reduce LBP
• Crook lying position also reduces LBP

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