Clinical Logbook: Doctor of Physical Therapy
Clinical Logbook: Doctor of Physical Therapy
Clinical Logbook: Doctor of Physical Therapy
DOCTOR OF PHYSICAL
THERAPY
DPT 7TH SEMESTER
COLLEGE OF PHYSICAL THERAPY
Assessment form
College of physical therapy GCUF
Department of physical therapy & rehabilitation
Surriya Majeed trust hospital
Name: S/O:
Age: Gender:
Marital status: Language:
Occupation: Address:
Mode of admission: Date of admission:
Medical Diagnosis:
Physical diagnosis:
Family history:
Objective evaluation:
ADL deficiencies:
Posture:
Lying
Sitting
Standing
Pain:
Onset
Nature
Radiating
Aggravating factor
Relieving factor
Severity (NRS)
Associated symptoms
Inspection:
Swelling:
Arrhythmia:
Joint deformity:
Muscle wasting:
Palpation:
Temperature:
Tenderness:
Edema:
Inflammatory sign:
Muscle wasting:
Contractures:
Examination:
Range of movement
Active:
Passive:
Muscle girth:
Limb length:
Differential test:
Gait assessment
MMT:
Neurological tests:
Dermatomes
Myotomes
Reflexes
Lab test:
Blood test
X-Ray
CT scan & MRI
Management
Short term goals:
Long term goals:
Intervention:
Manual therapy:
1.
2.
3.
Exercise therapy
1.
2.
Electrotherapy:
1.
2.
3.
Home plan:
Name of student:
Roll no:
Program:
Signature of student: -------------------------------
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Supervisor