Page 1

Client:

PT Client Management Canvas Âť Initial Data Medical diagnosis (Dx):

Date of Dx: Year

Month

Day

Date of birth: Year

Physical Therapist:

Month

Day

Gender:

Date of intake: Year

Month

Interview & informal observation

Guidelines, evidence & remarks

ICF Comprehensive Core Set for MS (2011); NICE MS guideline (2003); Shumway-Cook et al. (2012)

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Day


PT Client Management Canvas Âť Problem Tracking Problem list of activity limitation & participation restriction

Activities & participation

1

Client:

Physical Therapist:

Anna

(you!)

Date

Baseline Functional measures

Date

Goal Functional measures

Date

Progress / discharge Functional measures

Date

Testing & predictive criteria

Date

Testing & predictive criteria

Date

Testing & predictive criteria

Lack of confidence in balance when reaching forward, picking up something from floor, looking over shoulder or turning around. (E)

2

3

4

5

6

Problem #

Body functions & structures (and Contextual factors)

1

2

3

4

5

6

Hypotheses of causative impairments & other factors

1

Impaired motor component of balance strategy

2

Impaired sensory component of balance strategy

3

Impaired cognitive component of balance strategy

4

5

6

Decreased LE force generation

Decreased LE range of motion

Increased LE muscle tone

7

8

9

10

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This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/ or send a letter to Creative Commons, 444 Castro Street, Suite 900, Mountain View, California, 94041, USA.


PT Client Management Canvas Âť Examination Tests & measurements

Client:

Physical Therapist:

Anna

(you!)

Findings

Indications

Findings

Indications

Activities & participation

BBS

ABC - scale

Tests & measurements

Body functions & structures (and Contextual factors)

Alignment

Observational analysis: self-initiated sway forward, backward, side-to-side

Nudge test

Modified CTSIB

Isometric muscle force generation capacity - MRC- scale

Passive ROM - LE

MAS

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This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/ or send a letter to Creative Commons, 444 Castro Street, Suite 900, Mountain View, California, 94041, USA.


PT Client Management Canvas » Intervention Problem #’s

Hypotheses #’s

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Strategy

Tactic (description, intensity, duration & frequency)

Client:

Physical Therapist:

Anna

(you!) Implemeter

Progression & Remarks

This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/ or send a letter to Creative Commons, 444 Castro Street, Suite 900, Mountain View, California, 94041, USA.

/Anna_Canvas_33  

http://getptsmart.com/wp-content/uploads/2011/11/Anna_Canvas_33.pdf

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