Has there been a fall/ accident?
3
Can the patient lift their arm above their head?
4
Is there pain in the middle of the movement?
5
Holding arm out in front, with thumb down, push up against physio’s hands. Is it painful?
6
Hold arm up at 90° flexion with elbow bent. Internally rotate. Is it painful?
Impingement
Has there been a fall/ accident?
3
Can the patient lift their arm above their head?
10
Is the patient between 45-55 years old?
11
Can the patient move their arm as far as possible, even if painful, without help?
12
Put hand behind back. Can the patient lift hand away from body?
13
Can you lift the arm further than the patient can lift it?
Rotator cuff tear
Has there been a fall/ accident?
3
Can the patient lift their arm above their head?
4
Is there pain in the middle of the movement?
7
Lift arm across body. is it painful?
8
Is the patient older than 60 years?
9
Is it painful to touch the edge of the bony tip of the shoulder?
Shoulder osteoarthritis
Has there been a fall/ accident?
3
Can the patient lift their arm above their head?
10
Is the patient between 45-55 years old?
14
Is there a loss of external rotation?
Frozen shoulder
Has there been a fall/ accident?
15
Is there an obvious step down deformity at the edge of the shoulder?
16
Touch edge of shoulder. Is it painful to feel corner of shoulder?
17
Lift arm across body. Is it painful?
A/C joint dislocation
Has there been a fall/ accident?
15
Is there an obvious step down deformity at the edge of the shoulder?
18
Is the ball of the shoulder joint positioned more to the front of the chest?
19
Can the patient lift their arm up?
Shoulder dislocation
Has there been a fall/ accident?
15
Is there an obvious step down deformity at the edge of the shoulder?
18
Is the ball of the shoulder joint positioned more to the front of the chest?
20
Feel along upper arm and around shoulder blade. Is it painful?
Shoulder fracture
1. Do you have severe chest pain? Yes = see a doctor; No = 2;
2. Do you cough up blood? Yes = see a doctor; No = 3;
3. Is the in-breath louder than the out-breath (stridor)? Yes = see a doctor; No = 4;
4. Is the patient out of breath when speaking? (note: do their shoulders move to help them breathe) Yes = severe breathlessness; No = 5;
5. Do you now struggle with a normal activity such as walking, which didn’t happen before? Yes = ADL limited by breathlessness; No = 6;
6. How many sit to stands OR what distance walked in 2 minutes? Time/ distance = ?; go to 7;
7. What number does the patient point to for breathlessness? Number on scale = ?; go to 8;
8. can you hear crackles with your ear or stethoscope? Yes = sputum needs clearance; No = 9;
9. Can you feel the crackles with your hand? Yes = sputum needs clearance; No = 10;
10. Are the crackles high in the lungs? Yes = 11; No = sputum needs clearance;
11. Do you hear bronchial breathing or reduced breath sounds? Yes = go to doctor; No = 12;
12. Do you feel aches around your shoulders or chest from coughing and bringing up sputum? Yes = needs pain relief in sputum clearance; No = 13;
13. Are you drinking enough water? Yes = 14; No = de-hydrated;
14. Do you (the patient) have a lot of sputum? Yes = Sputum needs clearance; No = 15;
15. Does the amount of sputum bother you? Yes = Education in sputum clearance; No = 16;
16. Has your sputum changed colour or is it thicker? Yes = 17; No = 19;
17. Do you have bronchiectasis or COPD? Yes = Consider going to doctor; No = 18;
18. Do you feel ill/ have a temperature? Yes = Consider going to doctor, go to 19; No = drink water and monitor, go to 19;
19. Do you have problem with bringing up sputum? Yes = 20; No = 23;
20. Is the problem of bringing up sputum due to pain? Yes = Pain causing retention: requires clearance, massage and light exercises, go to 20; No = 21;
21. Is the problem of bringing up sputum due to weakness? Yes = Weakness: use sputum treatment, go to 22; No = 22;
22. Is the problem of bringing up sputum due to a social reason or embarrassment? Yes = Embarrassment, clear chest at home, go to 23; No = 23;
23. Do you wet yourself when coughing? Yes = Cough conrol and pelvic floor exercises, go to 24; No = 24;
24. Outcome measures (done after treatment): Is the sputum now clearer? Yes = 25; No = Repeat treatment;
25. Outcome measures (done after treatment): Can the patient now manage their own secretions? Yes = (finish); No = repeat treatment;