Physical Therapy Prescription

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Physical Therapy Prescription

• G. Reza Raissi MD
• Physical Medicine and Rehabilitation Dept.
• Iran University of Medical Sciences

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Strategies In Rehabilitation Medicine

• Prevent or correct additional Disability
• Stretching exercise for spastisity to prevent
  contracture
• Enhance system Unaffected by the Pathologic
  Condition
• Strengthening exercise in upper extremity of
  paraplegic patent to enhance transfer
• Enhance Functional Capacity of System affected by
  the disease
• PRE for weakened muscles
• Use of Adaptive equipment to promote Function
• Cane
• Modify Social and Vocational Environment
• Stairs
• Psychological Techniques
• mirror

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Therapy Referrals Requirements

• All referrals
• DISIPLINE(PT, OT, Rehab nurse)
• DIAGNOSIS
• EVALUATION REQUEST
• GOAL of Treatment with expected duration
• Intensity, Frequency, and Initial duration of Tx
• (Modified after reevaluation)

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All referrals

• Precaution
• Other diagnoses or problems that could
• impede or contraindicate certain
  interventions(Fracture, metal implant, PNP)
• Need monitoring
• Recommended limitations(No US over growth plate,
  no stretching beyond 30 degrees)

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All Referrals

• Mechanism of Feedback
• Date
• Signature
• Date of reevaluation by physician
• Request for phone consultation or progress report

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Specific Therapy referrals

• Specific Therapist name
• Specifics of monitoring desired
• Stop PT if pain aggravates

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• Diclofenac Tablet 25 mg
• once daily 20
• Hamstring stretching Gentle 30 second
• 3 times daily 10 days

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Problem Peroneal palsy with foot drop, likely
recovery in 6 months

• Goal Improve gait safety/efficiency and
  eliminate toe catching with ambulation prevent
  heal cord contracture
• One visit
• Dx Peroneal palsy with foot drop
• Precaution Mildly decreased sensation on foot
  dorsumgait instability Chronic hepatitis B
• Please
• evaluate and train the use of AFO including
  doning and duffing and skin cheks.
• Teach home program for Gastroc stretching
• Teach proper gait including stairs and rough
  train with can until pateint becomes comfortable
  with balance.
• I will follow up in 2 weeks, please send report

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Left Shoulder Adhesive Capsulitis

• Goal Improve shoulder external rotation and then
  abduction, while avoiding impingement to
  functional and possibly normal range.
• Date
• 12 visit/ 4weeks
• Dx Left Shoulder Adhesive Capsulitis
• Goals Improve External rotation by 20degree and
  Shoulder abduction by 30 degree By 4 weeks

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Left Shoulder Adhesive Capsulitis

• Precaution rotator cuff repair 12 wks ago
  increase risk of impingement pulleys are
  contraindicated
• Please evaluate and
• Manually stretch left shoulder, avoiding
  impingement while applying US to anterior then
  posterior joint starting at 1.5 watts/cm2 and
  adjust to highest level comfortable for 10
  minutes at each side

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• Add TENS if stretch is poorly tolerated
• Teach home program for self stretchng of external
  rotation ONLY(abduction to be added later)
• Rotator cuff strengthening with Teraband
• Reevaluation in 4 weeks
• Please send progress report including shoulder
  AROM and PROM measures each 2 weeks
• Please call 66066827 for any questions
• Thank you

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In the Name of God Patient Name and
family Date. Diagnosis Right
knee, ACL injury ,contracture Goal increase knee
ROM 20degree in 2 wks, Decrease Edema, Decrease
pain Physiotherapy ward Please ,Modalities Hot
Pack over knee Pulse US over contracture area in
posterior area and left tender point Electrical
Stimulation over quadriceps Exercise ROM
Active ROM, Strengthening Quadriceps
Isometrics(home edu), Leg press Stretching
quadriceps and hamstrings(home edu) Manual
therapy Massage, Patellar mobilization Gait
training partial weight bearing with double
crutch Attention use short lever arm, no
shearing force Three times per week for two
weeks
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