NEUROLOGICAL PHYSIOTHERAPY ASSESSMENT CHART

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

  

SPINAL REFLEXES: SUPERFICIAL REFLEXES: ABDOMINAL: BABINSKIS SIGN: 

DEEP TENDON REFLEXES  BICEPS  TRICEPS  SUPINATOR  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 

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

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  SHORT TERM GOAL  LONG TERM GOAL PHYSIOTHERAPY MANAGEMENT

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