Pediatric Evaluations
Physical therapy evaluations require a referral from a physician and a prescription. The evaluation starts with a review of the child’s history, including:
1. Prenatal status and possible complications
2. Birth history
3. Medical problems or complications
4. Current medications
5. Previous hospitalizations and surgeries or injuries
6. Gross motor milestones
Evaluation of the child’s gross motor skills is play-based and may include the following, depending on the needs of the child:
- Standardized testing, including the Peabody Developmental Motor Scales II, Alberta Infant Motor Scales, Bruininks-Oseretsky Test of Motor Proficiency and Gross Motor Function Measure.
- Assessment of Range of Motion (ROM), strength, muscle tone, reflexes, posture, balance, gait and functional ability. Parts of the evaluation are done with hands-on activities, while others are done by observing the child moving in the environment and interacting with toys or equipment or with the family. At the end of the evaluation, the therapist summarizes the findings and makes recommendations for follow up care to the family.
Orthopedic Evaluations
A. Subjective Exam
- Patient profile: age and activities now and before injury
- When/how the injury occurred
- Signs, symptoms and complaints
- What makes it better/what makes it worse
B. Objective Exam
- To determine exact cause/source of pain
- Establish baseline to monitor progress
1. Observation: posture/movements – which may contribute to the pain/problem
2. Range of motion: to compare motion of involved vs. uninvolved joint
3. Strength: to compare strength of involved vs. uninvolved joint
4. Palpation: to check for tenderness over specific sites (i.e., ligament, tendon)
5. Special tests: to determine specific area involved
6. Sensory exam: to rule out nerve involvement
7. Functional: to determine which functional activities the patient is unable to do or has difficulty performing
C. Assessment
- Summary of subjective and objective exam
- Refer to other health professionals, as needed
- Determine frequency of treatment required
D. Treatment Goals & Plan
- Establish according to the results of subjective and objective exam
- Issue an individualized home-exercise program