What is included in a Comprehensive PT evaluation?

Let’s take a look.

PAST MEDICAL HISTORY...

  1. Review of complete medical history (prior to appointment)

  2. Review of all symptoms

    1. Musculoskeletal:  Sprains, strains, subluxations, muscle spasms, posture, stiffness, instability

    2. Pain:  Joint, headaches, jaw, sacroiliac, widespread, injury, chronic

    3. Skin:  Wounds, bruising, pain to the touch, MCAS

    4. Cardiovascular:  POTS, orthostatic intolerance, Dysautonomia, heart rate/BP

    5. Psychosocial:  Depression, anxiety, fear of movement, 

    6. GI:  Constipation, bloat, abdominal pain, poor motility, food sensitivities/diet

    7. Allergy/Immunology:  MCAS identification and management

    8. Uro/Gyne:  Pelvic floor, pain with intercourse, incontinence

    9. Sleep:  Difficulty falling asleep, difficulty staying asleep, sleep hygiene

    10. Neuro:  Brain fog, dysautonomia, nerve pain, clumsiness, proprioception

    11. Other?

  3. Review of past PT - what worked and what did not (or what flared current condition)

  4. Review of current exercise routine - what able and not able to do, goals for exercise

  5. Discussion about things that are difficult to do: job, school, house, kids, recreation

  6. Review and discussion of patient’s goals for therapy

PHYSICAL EXAM…

  • Anatomy

  • Functional movements and movement patterns

  • Gait analysis

  • Balance assessment

  • Assessment of shoes and orthotics

  • Beighton Score assessment (upon request)

PT ASSESSMENT & PLAN…

  • Summary of evaluation and recommendations 

  • Plan of care and primary focus for ongoing PT

  • Goals for ongoing PT

  • Patient education briefly on (as appropriate):

    • EDS 101

    • Collagen 101

    • Hypermobility 101

    • Dysautonomia 101

    • POTS 101

    • MCAS 101

    • Other conditions that tend to occur with hEDS

    • Effects of EDS/HSD on body systems (thorough handout provided)

      • Musculoskeletal

      • Pain

      • Skin

      • Cardiovascular/Pulmonary

      • Psychosocial

      • GI

      • Allergy/Immunology

      • Uro/Gyne

      • Sleep

      • Neurological

PATIENT EDUCATION on…

  • Typical presentation of patient with hEDS

  • Avoidance of surgery

  • Pain management

  • Posture

  • Neuromuscular re-education 

  • Posture, Body Mechanics, Ergonomics

  • Muscle strengthening

  • Endurance/aerobic conditioning

  • Proprioception/Joint position sense

  • Psychosocial

  • Braces/splints/tape/assistive devices

  • Manual therapy

  • Nutrition

  • Sleep

  • How to manage long car rides, plane flights, sleep positions

  • How best to work with other medical professionals/ER

  • How best to manage autonomic dysfunction.

    • How best to manage flares/how to make a “flare plan.”

    • Pacing to avoid “boom/bust” cycle

  • Complementary therapies to consider

  • Treatment recommendations

    • Bracing/Splinting

    • Taping

    • Compression garments to consider

    • Soft tissue work needed

    • New movement patterns

    • Muscle strengthening

    • Muscle release techniques

    • Diaphragmatic breathing

    • Aerobic conditioning

    • Biofeedback

    • Postural setting 

  • Task specific training/Activities of Daily living/Vocational work

  • Explanation of exercises and handouts/video file for exercises to get started

  • Introduction to core stabilization – trunk, hips and neck

  • Posture – sitting, standing, body mechanics

  • Referral for further assessment (other medical professionals)

  • Access to video file of Wendy4Therapy educational resources

For an additional fee:

hEDS diagnostic worksheet w/results $150

Standing POTS test w/results $150

Clinical assessment of CCI.                   $150

Facilitation of genetic testing $150

Handicap license paperwork $150

Paperwork for disability (RFC). $150/hour