PATIENT EVALUATION

A.    Subjective:

•    Patient complaint

•    Location

•    Onset and duration of symptoms

•    Description of symptoms (i.e. numbness. pain [constant, dull, sharp] hypersensitivity. stiffness); use pain scale

•    Pattern of when symptoms occur (AM. PM. after activity, etc.)

•    Self-help or other formal treatment

•    Other medical problems

•    Concurrent medications and allergies

B.     Objective (also compare with uninvolved shoulder):

1.  Inspection

•    Carrying angle, arm posturing

•    Redness, swelling, warmth

•    Scars

2. Palpation:

•    Bone: acromion, humeral head, clavicle

•    Soft tissue: muscles and tendons (medially. posteriorly, laterally, anteriorly)

3. Mobility:

•  Active and passive ROM (flexion, extension.
internal and external rotation, abduction, adduc­
tion, horizontal adduction)

4. Muscle Testing:

•  Shoulder flexion, abduction, adduction, internal
and external rotation, extension, horizontal
adduction

5. Provocation Tests:

•    Impingement test - forced shoulder flexion against the anterior acromion. Pain indicates a positive result.

•    Drop ami test - (tests for a rotator cuff tear) the client should abduct the ami and then lower it smoothly from the abducted position. With a tear in the supraspinatus tendon, the ami will drop. If the ami can be held at 90° of abduction, even a slight tap on the arm will cause the ami to drop suddenly, indicating a rotator cuff tear.

6. Neurological:

•  Reflexes, sensation

7. Other Joints:

•  Test neck, shoulder, wrist and hand for secondary
involvement.

8. Review x-ray films and physician's report.

C.    Assessment:

1.     Problem list

2.  Goals

3.  Treatment:

 

•    Iontophoresis (medications, dosages, electrode size)

•    Other modalities (e.g.. ice or heat, stretching. strengthening, massage, home program, activity or sport re-education to prevent re-injury, etc.)

•    Oral or injectable medications (administered by physician, e.g., NSAIDs. corticosteroids)

D.     Plan:

1.     Frequency and duration of treatment.

2.  Date(s) for assessment of progress.

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Empi Dupel® Replacement Lead Wire

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IOMED® Phoresor TL7 Lead Wire Cable: For PM850 & PM900 Systems

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  Twin Lead Assembly For use only with PM850 or PM900 Iontophoresis Drug Delivery Systems.    
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