history

· age

· handedness

· occupation

· dwelling

· do you live in your own home ?

· who lives with you ?

· high or low set ?

1. pain

1. duration

2. onset

3. location

4. radiation

5. severity

6. night

7. rest

8. starting

9. exercise

10.relief

2. deformity

· change of shape

· stiffness

· instability

Knee

· swelling

· giving way

· locking

· clicking

Spine

· numbness or pins and needles

· weakness

· voiding

Shoulder

· slipping out

· catching

· clicking

3. function

Lower limb (modified Harris Hip Score)

1. limp

2. walking distance

3. public transport

4. stick (or walking aid)

5. stairs

6. shoes and socks

Upper limb (modified Heuston Shoulder Score)

1. throw objects (ball)

2. lift objects over head (suitcase on shelf)

3. comb hair

4. dress (put on coat)

5. reach back pocket or fasten bra

6. wash opposite underarm

Spine (modified Spine Society assessment)

1. lift small object (3 yo child)

2. sit for 1/2 hr

3. stand in one place for 1/2 hr

4. travel in car or bus for 1/2 hr

5. walk 1/2 km

6. shoes and socks

4. disability

· occupational

· usual work

· recreational

· sports

· hobbies

· ADL

1. females

· vacuuming

· shopping

2. males

· mowing

· home maintenance

5. treatment

1. patient

· weight loss

· activity modification

2. physical

· physiotherapy (local, ROM, strength, functional rehab)

· external appliances

3. pharmacological

· symptomatic (analgesics, NSAIDs, narcotics)

· disease-modifying (steroids, antirheumatoid)

4. profitable

· injections

· surgery

6. Past history

1. Medical

· heart problems

· heart attack

· angina

· high blood pressure

· lung problems

· asthma

· bronchitis

· emphysema

· other problems

· diabetes

· peptic ulcer

· steroids

· rheumatoid

· prostate

· thromboembolic

2. Medications

3. Habits

· cigarettes

· alcohol

4. Allergies

· antibiotics

· skin prep

· contrast