BSC PT - General Physiotherapy Assessent Form

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General Physiotherapy Assessment Chief Complaint

Body Chart Record the area of symptoms, behaviour of symptoms, aggravating factors, relieving factors, 24 hr pattern, VAS scale.

Past Medical History

Social History

Occupation/ Leisure activities

Special Questions - General health, Operations, Weight loss, Drugs (steroids, anticoagulants),
Rheumatoid arthritis (RA), Osteoporosis, Diabetes, Spinal cord/Cauda equina symptoms, Dizziness, X-rays, Working environment, Constant or night pain

For respiratory patients Check for cyanosis, breathing rate, heart rate, auscultation etc. For neurology patients complete neurological profile including sensory, motor and reflex assessment For musculoskeletal patients The subjective history would provide indication of the problem, so according to the area of symptoms, check Observation General and local, including gait and posture

Passive Movement

Active movements

Resisted isometrics

Accessory movements (Joint glides)

Muscle length tests (if needed)

Muscle strength tests (if needed)

Neurodynamic testing (if needed)

Palpation -

Special tests specific to the joint or structure suspected in the subjective assessment

Impression

Management Plan

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