Physiotherapist-Vorlage
Child Biomechanical Ax
Eine professionelle Physiotherapist-Vorlage für medizinisches Fachpersonal.
Über diese Vorlage
Need a detailed record of a child's biomechanical assessment? This template is perfect for physiotherapists. It covers everything from subjective findings and patient goals to posture, gait analysis, and specific tests like squats and hops. It also includes sections for treatment plans, home exercise programs, and advice. This template ensures a comprehensive evaluation, helping you document your findings accurately and efficiently. Heidi's AI scribe can quickly populate this template, saving you time and improving the quality of your documentation.
Vorlagenvorschau
Subjective:
Patient presents today with a complaint of right knee pain following a fall during a football match two weeks ago. The patient reports the pain is worse with running and jumping. The patient has been icing the knee and taking over-the-counter pain medication with minimal relief. The patient reports that the pain is a 6/10 on the pain scale.
Patient valued outcomes (PVOs):
Patient wants to return to playing football without pain.
Social Hx:
Patient is a 14-year-old male who is active in sports.
Posture:
Increased lumbar lordosis noted. Mild genu valgum bilaterally.
Gait:
Antalgic gait noted on the right side. Decreased knee flexion during stance phase on the right.
Run:
Patient unable to run due to pain.
Feet:
Normal arches noted.
Inv/Ev (Inversion/Eversion):
No significant findings.
Squat:
Patient unable to perform a full squat due to pain.
Unilateral Squat:
Unable to perform on the right side due to pain.
Jump:
Unable to jump on the right leg.
Hop:
Unable to hop on the right leg.
Up on Toes:
Full range of motion bilaterally.
Static Balance:
Good balance bilaterally.
Dynamic Balance:
Reduced balance on the right leg.
Flexibility:
Hamstring tightness bilaterally.
Strength:
Quadriceps strength reduced on the right side. Hamstring strength reduced on the right side.
Knees:
Tenderness to palpation over the medial joint line of the right knee. Mild effusion noted.
IMPRESSION:
Suspected meniscal injury of the right knee.
PLAN:
Further assessment with MRI. Commence physiotherapy treatment to address pain and improve range of motion.
TREATMENT:
Patient education on activity modification. Ice and elevation. Gentle range of motion exercises.
HEP (Home Exercise Programme):
Quadriceps sets, hamstring stretches, and gentle range of motion exercises.
ADVICE:
Advised to avoid activities that aggravate symptoms. Follow up with MRI and return for further physiotherapy.
NEXT DAY:
Review MRI results and progress with physiotherapy treatment.
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