daily note
{formmenu: Total Time Treatment: min; default=\ ; multiple=yes}
{formmenu: Total Time Code Treatment: min; default=; multiple=yes}
PROVIDED DURING TODAY’S VISIT:
{formmenu: Re-Evaluation Note Performed Today; Progress Note Performed Today; Discharge Note Performed Today; default=}
THERAPEUTIC ACTIVITIES: {formmenu: 8; default=10; 15; 13; 25; 30} minutes. Therapeutic activities performed today included instruction of {formmenu: advancement home exercise program; modification of home exercise program; review HEP for progressive flexibility and strengthening exercise including core stabilizer while strengthening LE. Additional HEP handouts dispensed to patient; review HEP for progressive flexibility and strengthening exercise including core stabilizer while strengthening UE. Additional HEP handouts dispensed to patient; default=; multiple=yes}. {formmenu: default=Patient; She; He} {formmenu: is educated about strategies for gradually progressing on frequency, intensity and duration; was educated about the importance of flexibility, strengthening and self-pace walking endurance; is educated about proper posture alignment during seated and standing activities; is advised to remove tape prior to attending therapy to reapply and to remove any adhesive on the skin.\ ; is educated and reinforce about precaution and surgical protocol; is advices to use cold pack as needed for pain management and after HEP\ ; is educated about scar tissue massage on the surgical scar area. Patient is instructed to apply steady downward pressure while moving in circular fashion for 5-10 min x 3x/day.; was recommended to gradually increase walking endurance to her maximal tolerance without significant pain; education about performing purse lip breathing and energy conservation during functional activity.\ ; was strongly recommended to use a cane for community ambulation especially if she is on uneven surface to manage instability; default=; multiple=yes} for {formmenu: core stabilization activation; default=UE; LE; shoulder; elbow; hip; knee; ankle; wrist; finger; neck; mid back; low back; multiple=yes} program. These activities were directed to focus on the patient’s restriction of mobility endurance with {formmenu: repetitive use of UE; repetitive use of hand; repetitive use of thumb/hand; reaching overhead; lift from the floor to waist height; pull/push; carrying weighted objects; lift and reach; squatting; walking endurance; step ups; step ups and over; weight bearing activity endurance; default=sit<>stand; gait training; jumping; gripping, grasping, twisting, bending, pinching; \ ; multiple=yes}. They require the professional skills of a therapist and were specifically designed to address the patient’s functional needs.
NEUROMUSCULAR RE-EDUCATION: {formmenu: 8; default=10; 15; 13; name=} minutes. Neuromuscular re-education was provided to facilitate muscle control with verbal, tactile and visual cues for proper muscle contraction during {formmenu: core stabilization strengthening; proper posture re-education; proper form therex; proprioception; balance; default=; multiple=yes}. Patient is also challenged with {formmenu: dynamic; static; static and dynamic; default=} {formmenu: balance; default=proprioception; balance and proprioception; } to reassure {formmenu: increase; default=decrease; improve; } {formmenu: left; default=right; bilateral; symmetrical\ ; } {formmenu: weight bearing shift correction; weight bearing to normalize equal bilateral balance in LE; default=} {formmenu: during\ ; default=while; with; } {formmenu: open chain exercises; default=close chain exercises; open and close chain exercises; maintaining good posture and core stabilization strengthening; maintaining good posture and core stabilization during UE strengthening; maintaining good posture and core stabilization during LE strengthening; maintaining good posture and core stabilization during LE and UE strengthening}.
Patient is challenged with static proprioception with wall ball for her {formmenu: R; default=L; bilateral} UE to improve {formmenu: default=GH joint\ ; elbow} awareness of its position to reassure stability and coordination of {formmenu: his; default=her} {formmenu: R; default=L; bilateral} shoulder/UE. Patient is also challenged with static proprioception while maintaining good posture and core stabilization during UE strengthening.
Patient is also challenged with proprioception exercises/activity using different textured such as soft, rough and different weighted objects to improve the awareness of {formmenu: her; default=his} {formmenu: right; default=left; bilateral} hand position when doing ADL.
{formmenu: default=Patient; He; She} is also challenged with proprioception exercises using laser pointer attached to a headband for {formmenu: his; default=her} neck {formmenu: left; default=right; left and right} rotation, flexion and extension while seated with eyes {formmenu: default=open; close} to improve cervical spine muscle control, coordination and precision. PNF D2 flexion with cervical spine extension and upward gaze; horizontal abduction combined with cervical spine rotation.
THERAPEUTIC EXERCISES: {formmenu: 8; default=10; 15; 13} minutes. {formmenu: Advanced; default=Modified} therapeutic exercise included for cardiovascular. {formmenu: Patient\ ; default=Mrs.; Mr.}used {formmenu: UBE; default=treadmill; recumbent bike; NuStep; upright bike; } to improve general muscular and cardiovascular conditioning benefit, hypoalgesic effect, increase tissue extensibility and strength of {formmenu: UE; default=LE; general conditioning}. These exercises included {formmenu: AROM exercises; default=AAROM exercises; PROM exercises; blocked ROM exercises; therapy ball for ROM,; stretching,; multiple=yes} {formmenu: isometric strengthening; isotonic strengthening; strengthening; therapy ball for strengthening; grip/pinch strengthening; default=\ AROM exercises, PROM exercises, stretching for L hamstrings, isometric strengthening for L quadriceps,
and general bilateral LE strengthening; calisthenics strengthening\ ; Patient used pulley to improve general AAROM exercises and AROM exercises of L shoulder flexion and scaption plane.; Progressed to reactive isometric strengthening exercises conditioning for R shoulder planes.; ; multiple=yes} {formmenu: during; while; default=} {formmenu: open chain exercises; default=close chain exercises; open chain and close exercises; Progressed to reactive isometric strengthening exercises conditioning for all shoulder planes.; Patient used pulley to improve general AAROM exercises and AROM exercises of L shoulder flexion and scaption plane.; multiple=yes} conditioning.
MANUAL THERAPY: {formmenu: 8; default=10; 15; 13} minutes. Manual therapy performed by therapist today which included {formmenu: scar mobilizations to soften surgical scar tissue; edema mobilizations; nerve glides; cross-friction massage; contract relax\ ; soft tissue mobilizations to desensitize; proprioceptive neuromuscular facilitation\ ; dynamic cupping; IASTM; myofascial release; manual traction; tIbialfemoral distraction with PROM in high seated; rhythmic stabilization with perturbation at 90 shoulder flexion; soft tissue mobilization with stretching; multiple=yes} to the {formmenu: right; default=left; bilateral} {formmenu: knee; default=elbow; wrist; lumbosacral; thoracolumbar fascia and quadratus labarum area; cervical spine; shoulder; ankle; hip; quadriceps and IT band; thumb; finger; multiple=yes}. Also provided {formmenu: PROM; default=joint mobilization grade I/II; joint mobilization grade II/III; PROM with stretches; AAROM with stretches; contract and relax techniques; patella mobilization\ ; ; multiple=yes} of {formmenu: left; default=right; bilateral} {formmenu: shoulder; default=elbow; wrist; thumb; digits; hip; knee; ankle; hallux; cervical spine; lumbar spine; thoracic spine; LE; digit; multiple=yes} to improve {formmenu: flexion; extension; default=abduction; external rotation\ ; internal rotation; dorsiflexion; normalize muscle tone and myofascial mobility; supination; pronation; rotation; multiple=yes}.
Also provided joint mobilization grade I/II of CMC, MCP, STM of {formmenu: right; default=left; bilateral}
hand/wrist to desensitize and soften surgical scar tissue and improve myofascial mobility.