NEUROLOGICAL PHYSIOTHERAPY ASSESSMENT CHART

NEUROLOGICAL PHYSIOTHERAPY ASSESSMENT CHART SUBJECTIVE EXAMINATION

NAME:  AGE: SEX : RACE: OCCUPATION: HANDEDNESS: DATE OF ADMISSION: CHIEF COMPLAINTS: HISTORY:

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PRESENT HISTORY PAST HISTORY MEDICAL HISTORY FAMILY HISTORY PERSONAL HISTORY SOCIAL HISTORY

OBJECTIVE EXAMINATIONS ON OBSERVATION

BUILD  ATTITUDE OF LIMBS 

IN LYING  IN SITTING  IN STANDING POSTURE 

AP VIEW  PA VIEW  LATERAL VIEW GAIT ANAYALYSIS DEFORMITIES

 ANY EXTERNAL APPLIANCES: ON PALAPATIONS

TENDERNESS SKIN TEMPERATURE SWELLING OEDEMA CLUBBING ON EXAMINATIONS

HIGHER MENTAL FUNCTIONS ORIENTAION MEMORY 

SHORT TERM  LONG TERM  REMOTE BEHAVIOUR SPEECH INTELLIGENCE CRANIAL NERVER ASSESSMENT MOTOR EXAMINATIONS

  A. MUSCLE GIRTH MEASUREMENT B. MUSCLE POWER C. TONE  AXIAL UPPER LIMBS LOWER LIMBS VOLUNTARY CONTROL EXAMINATIONS REFLEXES:     

0 = No response 1+ = Low normal or diminished 2+ = Normal 3+ = Brisker than normal. But may not indicate disease 4+ = Hyperactive very brisk spinal cord disorder 

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SPINAL REFLEXES:  SUPERFICIAL REFLEXES:  ABDOMINAL:  BABINSKIS SIGN:

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DEEP TENDON REFLEXES  BICEPS  TRICEPS 

SUPINATOR

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KNEE JERK  ANKLE JERK MYOTOME TESTING

DERMATOME TESTING MUSCLE LENGTH TESTING CONTRACTURES/DEFORMITIES SENSORY EXAMINATIONS SOMATIC SUPERFICIAL 

LIGHT TOUCH  PAIN  TEMPERATURE DEEP 

VIBRATIONS SENSE  JOINT POSITIONS SENSE CORTICAL 

STEREOGONOSISI  GRAPHESTHESIA  BARAGNOSIS DISCRIMINATIVE 

TWO POINT DISCRIMINATION

DERMATOME TESTING ROM MEASUREMENT

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UPPER LIMB  LOWER LIMB  SPINE LIMB LENGTH MEASUREMENT 

TURE  APPARENT  ABNORMAL MOVEMENTS BALANCE AND CO-ORDINATIONS BALANCE 

STATIC  DYNAMIC CO-ORDINATION 

FINGER TO NOSE TEST DYSDIADOKOKINESIA HEEL TO SHIN WASH BASIN SIGN ROMBERGS SIGN TANDEM WALKING

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BLADDER/BOWEL CONTROL CARDIO RESPIRATORY VITAL SIGNS 

TEMPERATURE  PULSE RATE  RESPIRATORY RATE  BLOOD PRESSURE BREATING PATTERN CHEST EXPANSION CHEST DEFORMITY  AUSCULTATION LUNG SECRETIONS GASTROINTESTINAL EXAMINATIONS:

FUNCTIONAL ACTIVITY EXAMINATION     

EATING DRINKING BATHING TOILETING COMBING

PROVISIONAL DIAGNOSIS DIFFERENTIAL DIAGNOSIS INVESTIGATIONS DIAGNOSIS PROBLEM LISTING PLAN OF TRETMENT

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SHORT TERM GOAL  LONG TERM GOAL PHYSIOTHERAPY MANAGEMENT