FACULTY OF SPORT SCIENCE AND RECREATION

BACHELOR OF SPORT SCIENCE

SUBJECT COURSE:
SPS609: APPLIED EXERCISE AND SPORT REHABILITATIONS

TOPIC:
INDIVIDUAL ASSIGNMENT: SOAP FOR LOWER BACK PAIN

PREPARED BY:
NORHUZMAIRA BINTI MOHD ROFAEI (2021352671)

PREPARED FOR:
MADAM NURUL AIN ABU KASIM

DATE OF SUBMISSION:
3 JUNE 2022

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TABLE OF CONTENT

NUM CONTENT PAGES

1. 1.0 Client’s Background 3

2. 2.0 Subjective 4

3. 3.0 Objective 5-7

- Observations
- Palpations
- Special Test

4. 4.0 Assessment 8

5. 5.0 Plan 9-12

6. 6.0 Appendices 13
7. 7.0 References 14

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1.0 CLIENT’S BACKGROUND

NAME Farah Balqis Binti Mohd Faizal

AGE 22 years old
DATE OF BIRTH 28 June 2000
GENDER Female
ADDRESS B-12-2 Mount Karunmas Jalan Karunmas 5 Taman Desa
Karunmas Balakong 43300 Seri Kembangan Selangor
NUMBER PHONE 019-3233093
HEIGHT 151 cm
WEIGHT 40 kg
FINAL DIAGNOSIS Idiopathic Scoliosis

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2.0 SUBJECTIVE
2.1 History of Injury
i. Client’s Impression
Idiopathic scoliosis is one of the three types of scoliosis that causes an
abnormal curvature in the spine. As the word idiopathic implies “without a
known cause”. This injury usually affects in families and females more
frequently than males. Idiopathic scoliosis is often minor and requires no
treatment other than close monitoring. It happens at thoracic 4 until Lumbar
3. Thus, my client also state that after she have been diagnosed in this
injury, she have feel physically and emotionally exhausted over time. She
also feel too conscious about appearance and as she cannot participate in
a lot of activities thus feel left out most of the time.
ii. Site of Injury- Thoracolumbar spine
iii. Mechanism of Injury- Removal of the ribs from one side that will produces
an imbalance in the symmetric weight transmission through the ribs on the
two sides.
2.2 Behavior of Symptoms
Criteria Description
Provocation of symptoms  Quickly feel exhausted
 Feel the pain if too much of
movement
Severity of symptoms  Pain scale 7 out of 10 before
surgery
Region of symptoms  Localized

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3.0 OBJECTIVE
3.1 Observations

Figure 1: Posterior Position Figure 2: Anterior Position

Based on my observations, this patient have idiopathic scoliosis which it happens without
a known cause. Thus, scoliosis is a sideway curvature of the spine that most often will be
diagnosed in adolescents. However, we can see the condition of her body after her post surgery
which it shows that her condition of the spine is still visible tilted. In this part, it is really important
to check and observe their postural alignment either their condition is normal or abnormal posture.
We can see for this patient, their posture are abnormal as it refer to rigid body motions and
persistent abnormal body postures. Poor posture can lead them to have a strain in their body
which it will cause the pain, muscle tightness or weakness. It gives her a difficulty in having their
ideal posture as their back position will slightly tilted. In order to observe their posture, the test
should be done with weight bearing which is in standing position and we can viewed their posture
from different angle such as anterior, posterior, medial and lateral. This views will showed us the
differences of position in their back body. Most cases in idiopathic scoliosis does not cause
symptoms but it develop pain at their back. Lower back pain occurs for many reason as it include
inability to stand upright due to weakness of the core musculature. Their leg will feel pain or even
numbness if there is a pressure at their lumbar spine. In order to detect the area of the injury, we
need to do the special test as it help to determine the structural or functional scoliosis.

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 3.1.1 Palpation

Palpation is one of the method in observations and inspections as it help to identify the
localized and pain part at their body. Palpation can start with gentle and assuring touch which you
can slowly touch and palpate your patient’s body as it will shows some reaction if there is any
trigger points. Trigger points is a sensitive area of the body that will cause a specific effect at their
body.

3.2 Special Test

3.2.1 Active Range of Motion

Next for the special test that we have choose for idiopathic scoliosis patient that called as
Adam’s forward bend test. The purpose of this test is to detect or determine their structural and
functional scoliosis because it is really helpful when the characteristics of the scoliosis becomes
more visible while the patient bends. This test also can be performed in the standing position and
sitting position.

Procedure of Adam’s forward bend test:

i. The patients need to take off her shirt so that the spine is visible
ii. The patient need to bend forward as it will start at the waist until the back comes in the
horizontal plane.
iii. Their feet need to be together with both arms hanging and the knees in the extension
position

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 iv. The palms are held together
v. The examiner will looks from behind along with the horizontal plane of the column of
vertebrae.
vi. The examiner will looks for indicators of scoliosis such as spinal asymmetry, un-level
shoulder, un-level hips, scapula asymmetry and the head does not line up with the
pelvis or rib hump.

3.2.2 Passive Range of Motion (PROM)

Procedure of Hip Flexor Stretch:

i. You need to kneel on your affected leg and bend your good leg out in front of
you, with that foot flat on the floor.
ii. If the patient feel discomfort in the front of your knee, you can place a towel
under your knee
iii. While you keep your back straight, the physical trainer can slowly push the
patient’s chest until you feel a stretch at your lower back.
iv. Hold the stretch for at least 15 to 30 seconds
v. Repeat 2 to 4 times
vi. Please note for any abnormal sign such as clicking sounds

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4.0 ASSESSMENT

Based on my observations, we can see from their history of the injury this client has
been diagnosed with idiopathic scoliosis where the condition of the spine is tilted. This injury can
be refer as ‘without a known causes’ which usually happen in adolescent. As this client already
done with their surgery, she tend to feel exhausted if she put too much pressure at their back as
they need to sit for a long time and she cannot give too much movement as it will trigger the
pain. Moreover, scoliosis also can be defined by the Cobb’s angle of spine curvature. In order to
determine their posture either in abnormal or normal condition, we can observe her body by
using the postural alignment which the client need to stand straight in order for us to check her
posture and it shows that the condition of her body is abnormal. We can see that her body is a
bit tilted after their surgery and it tend to feel pain if she put pressure on it.

As for the special test, we choose to do with Adam’s forward bent test as it can
determined their level of tilted spine even though this client has done with their surgery. This
test is really easy and it did not involve with any weight as the client need to bend their body and
we can see clearly the condition of her body like in the picture above. Even though this client
has done with her surgery, her condition of the body will not improve 100% as she also need to
do a rehabilitation program which it will help her to reduce her pain, increase her motivations
and also can return her back to do any works or exercise without feel too much pain.

5.0 PLAN

For the last step in SOAP notes, we need to formulate the treatment plan as it is the
training program for the client to do some rehabilitation session. The purpose of this treatment
plan is that the client can reduce her risk of back pain, as she can feel better by doing this
treatment plan. The client also need to know what she need to achieve in this treatment plan as
the physical trainer can help with the exercise. Thus, we should provide her some treatment
plan after her post surgery which it will improve her back pain and she can return back to her
work in the comfortable condition.

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Week 1: Monday (Day 1)

INTRODUCTION EXERCISE INTENSITY NOTES

DESCRIPTION
Warming up (Static) Make sure the
- Upper back client’s heart rate
Stretch 15 second hold each is ready to
- Shoulder Stretch exercise proceed with the
- Hamstring Stretch main activity.
Main Activity
- Pelvic Tilts 10 repetitions with 3 Low intensity The client wear a
- Arm and Leg set each exercise (10%-30%) proper attire to
Raise reduce from any
- Bird Dog *rest between set and serious injury
Cooling Down exercise 1 minutes
- Seated forward
bend 30 second hold each
- Kneeling Reach exercise
- Cobra

Week 1: Tuesday (Day 2)

INTRODUCTION EXERCISE INTENSITY NOTES

DESCRIPTION
Warming up (Static) Make sure the
- Upper back client’s heart rate
Stretch 15 second hold each is ready to
- Upward salute exercise proceed with the
pose main activity.
- Half forward bend
Main Activity The client wear a
- Sitting rotation 10 repetitions with 3 Low intensity proper attire to
Stretch set each exercise (10%-30%) reduce from any
- Cat and Cow serious injury
Stretch

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 - Bird dog Stretch *rest between set and
Cooling Down exercise 1 minutes
- Seated forward
bend 30 seconds hold each
- Kneeling Reach exercise
- Cobra

Week 1: Thursday (Day 3)

INTRODUCTION EXERCISE INTENSITY NOTES

DESCRIPTION
Warming up (Static) Make sure the
- Standing forward client’s heart rate
bend 15 second hold each is ready to
- Half forward bend exercise proceed with the
- main activity.
Main Activity
- Child pose 1 minute hold each The client wear a
- Knee to chest exercise, repeat 3 sets Low intensity proper attire to
stretch (10%-30%) reduce from any
- Piriformis stretch *rest between set and serious injury
Cooling Down exercise 1 minutes
- Ragdoll
- Down dog 30 seconds hold each
- Low lunge exercise

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Week 1: Friday (Day 4)

INTRODUCTION EXERCISE INTENSITY NOTES

DESCRIPTION
Warming up (Static) Make sure the
- Pelvic tilts client’s heart rate
- Cat and cow 15 second hold each is ready to
stretch exercise proceed with the
- Latissimus dorsi main activity.
stretch
Main Activity Low intensity The client wear a
- Child pose 1 minute hold each (10%-30%) proper attire to
- Bird Dog Crunch exercise, repeat 3 sets reduce from any
stretch serious injury
- Cobra *rest between set and
Cooling Down exercise 1 minutes
- Ragdoll
- Down dog 30 seconds hold each
- Low lunge exercise

Week 1: Sunday (Day 5)

INTRODUCTION EXERCISE INTENSITY NOTES

DESCRIPTION
Warming up (Static) Make sure the
- Upper back stretch client’s heart rate
- Upward salute 15 second hold each is ready to
pose exercise proceed with the
- Cat and cow main activity.
stretch
Main Activity Low intensity The client wear a
- One legged king 1 minute hold each (10%-30%) proper attire to
pigeon exercise, repeat 3 sets

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 - Wide child pose reduce from any
- Bird Dog Crunch *rest between set and serious injury
stretch exercise 1 minutes
- Cobra
Cooling Down
- Kneeling reach 30 seconds hold each
- Cobra exercise
- Knee to chest

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6.0 APPENDICES

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References
Allen, S. (2021, August 5). Abnormal Posturing. Retrieved from https://www.healthline.com:
https://www.healthline.com/health/decorticate-posturing#outlook
Brennan, D. (2020, November 19). Best Exercise for Scoliosis. Retrieved from
https://www.webmd.com: https://www.webmd.com/back-pain/best-exercises-scoliosis
Cleynenbreugel, H. V. (2022, June 2). Adam's forward bend test. Retrieved from
https://www.physio-pedia.com: https://www.physio-
pedia.com/Adam's_forward_bend_test
Maes, G. (2022, June 2). Scoliosis. Retrieved from https://www.physio-pedia.com/Scoliosis:
https://www.physio-
pedia.com/Scoliosis#:~:text=Scoliosis%20is%20usually%20confirmed%20through,radio
graph%2C%20CT%20scan%20or%20MRI.&text=See%20link-,.,See%20link.
Professional, M. (2019, September 25). Adult Scoliosis. Retrieved from
https://my.clevelandclinic.org: https://my.clevelandclinic.org/health/diseases/15837-adult-
scoliosis

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