MODUL PRAKTIKUM

ASSESMENT DAN DIAGNOSA FISIOTERAPI

STATUS KLINIK

A. DATA-DATA MEDIS RUMAH SAKIT

a. Diagnosa medis
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b. Catatan Klinis
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c. TerapiUmum
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B. PEMERIKSAAN FISIOTERAPI
1. Anamnesis
a. Anamnesis Umum
Nama
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Umur
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Alamat
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Jenis kelamin : ( L / P )
Agama
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Pekerjaan
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b. Anamnesis Khusus
Keluhan Utama
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Riwayat penyakit
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Riwayat penyakit dahulu
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Riwayat penyakit penyerta
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c. Anamnesis Sistem
1) Musculoskeletal
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2) Kardiovaskuler
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3) Respirasi
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4) Neuromuscular
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2. Pemeriksaan Fisik
a. Vital Sign
 Tekanan Darah
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  Denyut Nadi
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 Pernapasan
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 Temperatur
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b. Inspeksi
 Statis
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 Dinamis
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3. PemeriksaanSpesifik
a. MMT :
b. Tes Tonus otot :
c. Tes Keseimbangan :
d. Pengukuran Nyeri :
e. Tes Koordinasi :
f. Tes Apresiasi Reaksi :
g. Tes Sensorik :
h. Tes Reflek :
i. Tes Rasa Posisi :
j. Tes Transfer :
k. Tes ADL :
4. Kognitif, intrapersonal, dan interpersonal
Kognitif :
 Intrapersonal :
Interpersonal :

C. DIAGNOSIS FISIOTERAPI
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D. PROBLEMATIK FT
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E. PROGRAM RENCANA TINDAKAN FISIOTERAPI

1. Tujuanjangkapanjang :……………………………………………………………..

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2. Tujuanjangkapendek :……………………………………………………………..

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F. INTERVENSI FISIOTERAPI
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G. PROGNOSIS
Quo ad vitam
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Quo ad sanam
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Quo ad fungsionam
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Quo ad cosmeticam
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H. EVALUASI
1) Evaluasisesaat :…………………………………………………………………............

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2) Evaluasiberkala
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I. HASIL TERAPI AKHIR

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J. HOME PROGRAM
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K. UNDERLIYING PROCESS
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