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Philippine Heart CenterComprehensive Cardiac Rehabilitation

Physical Therapy Initial Evaluation

Date of Evaluation: Nov. 17, 2014

S>M.P., a 36 y/o (-)tn/DM/!"t#$a, (%)-#an&e& fe$ale 'a" efee& fo Peval * M+ 2 to c/oae#en"ion in &oin !D", "u# a" 'alin * li$in"tai", &/t #eat oeation. Pt. al"o /o on"tant, loalie&, "#a, a#in ainon ini"ion "ite a&e& 4/10 at e"t '#i# i$$e&iately aavate" to /10

uon $ove$ent of 5 "#oul&e u to 0(a" &e$on"tate& y t.) o uon

e+etion ("u# a" in e& $o * tan"fe"), an& i" a&ually elieve& y Me&"to 3/10. Pain 'a" &e"ie& a" 8aan "uat na $aiot, #ini#ila aoaaa.9 HPI:10 yea" ao, t. "tate& e+eienin ea"y fatiueaility *alitation". No on"ult 'a" &one, t. inoe& + * ont. eula !D". 4$o". P;E (

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$, an& &i"tane fo$ one oo$ to anot#e in 'o lae i" 2$. Pt&s'oal: 8o o a to $y e$oi& "tatu".9

(>JK 5PK a L 0/60 $$ L 100/60 $$ %K a L 0 $ L6$

%%K a L1 $ L23$ F2 at: a L L

e$: 36.7= Bin&in": J ae "tale iniAane: Bo eautionay $ea"ue

F;K 5e&fa"t K Eto$o# K Not in aaent ain o e"iatoy &i"te"" K (O) >aue on "tenal aea K (O) ;J line on &o"u$ of % #an& K (O) Po"tual &eviation" ("ee P!) K (O) >ait &eviation ("ee >!) K (-) E+e""ive "'eatin K (-) =ental an& Pei#eal =yano"i" K (-) o#i "in #ane" on (5) ?E/E

PalK No$ot#e$i (5) ?E/E K (O) >. 2 ten&ene"" on (5) ue a K (O) No&ule" on (5) ue a K (O) i#tne"" of (5) ue taeiu" K (O) Non-ittin e&e$a on (%) #an& K (-) Mu"le "a"$ on (5) ue taeiu" K (-) E&e$a on () ?E * (5) E%FMK !ll $aIo Ioint" of (5) ?E/E * ne 'ee atively * a""ivelya""e""e& to e GN, ain-fee, * (N) en&-feel", e+et fo:

)R( PR( *ormal

+alue

,i-erenc

e

End#eel

01Shoulder2le!

0-0 N/! 0-10 !%FM: 0P%FM: N/!

E$ty

01Shoulder)bd

0-0 N/! 0-10 !%FM: 0P%FM: N/!

E$ty

01 "at 0-30 0-4 0-4 !%FM: 1 Bi$

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*ec% 2le! P%FM: 0

Bin&in": FM of (5) "#oul&e e+ * a& an& (5) lat ne e+ !%FM;nteetation: FM of (5) "#oul&e &/t ain. P%FM of (5) "#oul&e e+, a&, *e+t not a""e""e& &/t "uial eaution. (5) Ne lat e+ FM &/t ti#tne""of (5) ue ta". %FM of (%) 'i"t not a""e""e& &/t e"ene of ;J line.

MMK !ll $aIo $u"le" of (5) ?E/E 'ee o""ly a&e& /, e+et fo:

(5) "#oul&e e+ L 3/

(5) "#oul&e a& L 3/

%e$a": %e"i"tane 'a" not iven aain"t e+ an& a& &/t "uialeaution".

=a&ioul$onay !""e""$entKK !u"ultation

K !#yt#$ia

K (-) Mu$u"

K (-) =ale" on (5) lun"

K (-) G#eee" on (5) lun"

K Dy"nea "ale: >a&e 1

K Pul"e >a&e: 2O (t#ea&y)

K =#e"t e+an"ion $ea"ue$ent

Inhale inches1 E!hale inches1 ,i-erence

inches1

)!illa 2. 24. 1

3iphoid Process 22. 21 1.

Subcostalar'in

21. 20 1.

Po"tual !""e""$entK !ll o&y lan&$a" vie'e& fo$ !P * lateal vie'" in"tan&in, 'ee a""e""e& to e aline&, e+et fo:

)nterior +ie4 Posterior +ie4 "ateral +ie4

(%) "#oul&e #i#e

t#an ()

(%) "#oul&e #i#e

t#an ()

(O) Potate&

"aula

(O) Bo'a& #ea&

o"tue

t#oai y#o"i"

Bin&in": Pt. $ay e in a otetive o"tue, 'it# inea"e& t#oai y#o"i"an& otation of "aula &/t ae#en"ion fo$ "uial ini"ion

>ait !""e""$entK !$ " !D all aa$ete" of ait a""e""e& to e N uon'alin fo 0$ on levele& "ufae. #e follo'in ait &eviation" 'eenotie&:

R1 "1

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Stance Phase

;nitial =ontat Q DB Q DB

oa&in %e"on"e N N

Mi&"tane N N

e$inal tane Q PB Q PB

Pe-"'in N NSwing Phase

;nitial 'in N N

Mi& 'in Q i * Hnee Ble+ion Q i * Hnee Ble+ion

e$inal 'in N N

Q (5) te lent#

Q (5) ti&e lent#

Q =a&ene

N 5F

Buntional !""e""$entK ;n&e in all a"et" of !D", e+et fo: Min &iR in "elf-ae, fee&in, e& $o, * tan"fe" a" $anife"te& y

"lo'ne"" in &oin ta" &ue to ae#en"ion

Min &iR O1 a""i"t in &onnin * &oSn #o"ital o'n &/t ae#en"ionfo$ "uial ini"ion

N "ittin * "tan&in toleane

N "ittin an& "tan&in alane

6-$inute 'al te"t: 0$, F5 %PE: 13

)>P D+K MD D+ of !tial etal Defet: eun&u$ ye "/ an"t#oai(!nteolateal #oaoto$y) !D lo"ue fut#e &eAne& y $in &iR in "elf-ae, fee&in, e& $o, * tan"fe", $in &iR O1 a""i"t in &onnin * &oSn

#o"ital o'n 2ain, FM, * &eea"e& =J en&uane.

Pono"i"K >FFD

Pt. #a" a oo& ono"i" "ine no o$oi&itie" ae e"ent t#at $ay

fut#e o$liate * aRet t#e outo$e" of t#e "uey an& t#e oe""in t#eay. #e t. "#o'" ative ooeation, atiiation, * aeene toP $anae$ent an& in"tution" ovi&e&. >eneal info$ation "#o'e& no

i" fato" t#at $ay o"e a" a ole$ o #in&ane. #ee 'ee nooIetive a""e""$ent" t#at 'ee out of t#e no$al o t#at $ay "eve a"fut#e o$liation fo a o"t-oeate& atient.

;ntevention enaioK

Pi$ay: %EF%E

o 5eau"e 'e 'ant t#e t. to etun to #e e-$oi& "tatu" an&

to $aintain #e "tent# an& %FM a" "uial eaution" e$ain

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eon&ay: !D!P

o 5eau"e t#e t. nee&" to $o&ify #e ativitie" &/t "uey

eaution".

Pole$ i"tK

1. Deea"e& =J en&uane2. Pain on ini"ion "ite a&e& 4/10 at e"t, /10 uon $ove$ent K03. FM of (5) "#oul&e e+ an& a&4. Min &iR in "elf-ae, fee&in, e& $o, * tan"fe". Min &iR O1 a""i"t in &onnin * &oSn #o"ital o'n6. Po"tual &eviation"7. Geane"" of (5) "#oul&e e+o" an& a&uto" a&e 3/. >ait Deviation"

>K%e#ailitativeK Pt. 'ill e ale to 'al fo 10$ on levele& "ufae in

6$in" %PE of 11 2 '". of P "e""ion".

PeventiveK Pt. an& aeive 'ill no' an& vealie o"t-"ueyeaution", eventin t#e Jal"alva $aneuve, an& 'ill no' t#ei$otane of aein to 'a& in"tution" 1 P "e""ion to evento$liation" an& to failitate eovey.

>K

1. Pt. 'ill &e$on"tate =J en&uane a" $anife"te& y ein ale to

ove 100$ in t#e 6-$inute 'al te"t %PE of 13 1 'ee of P"e""ion"

2. Pt. 'ill eot of ain on ini"ion "ite fo$ 4/10 1/10 1 '. of P

"e""ion" to e ale to &o !D" ea"e

3. Pt. 'ill &e$on"tate %FM of (5) "#oul&e e+ * a& y 10'it#in

allo'ale ane &ay" of P "e""ion" to e ale to &o !D" le""&iSulty

4. Pt. 'ill &e$on"tate &iSulty in "elf-ae, fee&in, e& $o, *

tan"fe" fo$ $in no &iR a" $anife"te& y efo$ane ti$e 1

'. of P "e""ion"

. Pt. 'ill e ale to &on * &oR #o"ital o'n fo$ $in O1 o$letely

in&een&ent &ay" of P "e""ion"

6. Pt. 'ill &e$on"tate o"tual &eviation" a" $anife"te& y t#oaiy#o"i" * fo'a& #ea& o"tue &ay" of P "e""ion" to event illeRet" of oo o"tue

7. Pt. 'ill $aintain 3/ "tent# of (5) "#oul&e e+o" * a&uto" 2'". of P "e""ion" to event &eteioation of on&ition

. Pt. 'ill &e$on"tate oe ait $e#ani" "u# a" (5) PB, DB, #i *nee e+ion 1 ' of P "e""ion" fo ea"e in $oility

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P>Pt. 'ill e "een an& teate& a" an in t. o& t#e follo'in P M+:

1. =ol& a" on ini"ion "ite + 20 $in to ain

2. DD5E + e" + 1 "et to tea# oe eat#in te#niCue &uin&y"nea

3. Buntional tainin in e& $o an& tan"fe" inooation of oete#niCue u"in veal, vi"ual, * tatile ue" + 3 e" to failitate ea"ein $ovin

4. Po"tual oetion in font of $io u"in veal, vi"ual, an& tatileue" to i$ove o"tue

a. =#in tuin e+ei"e. aula etation a" toleate&

. !%FM" of (5) ?E to'a&" all $otion" 'it#in allo'ale ane + 10 e" +2 "et to $aintain Ioint inteity

6. P%E" of (5) E to'a&" all $otion" u"in 2 l !G + 10 e" + 2 "et to$aintain $u"le "tent#

7. all'ay a$ ait etainin u"in veal ue" a" toleate& to i$ove=J en&uane an& i$ove ait

Ga& in"tution":1. DD5E + e" o a" nee&e& to tain oe eat#in an& to a&&e""

&y"nea2. Po"tual oetion a" nee&e& u"in veal an& tatile ue" y

aeive a" nee""ay to #el i$ove o"tue3. =ou#in "lintin + 3 e" + 2 "et" to tain ou#in4. !%FM" of (5) ?E to'a&" all $otion" 'it#in allo'ale ane + 10 e" +

2 "et to $aintain Ioint inteity

Pt. E&uationKPt. an& aeive "#oul& e no'le&eale of #e on&ition,

eautionay $ea"ue" t#at "#oul& e o"eve&, an& #ane" t#at "#oul&e i$le$ente& 'it# ea& to #e life"tyle. Pt. "#oul& e o$liant 'it# t#e'a& in"tution" an& "#oul& &in #e $e&iation" io to t#e t#eay"e""ion. Pt. "#oul& atie eney on"evation te#niCue" to event ovee+etion. Pt. "#oul& al"o avoi& elevatin #e a$ eyon& 0 unle"" leae&y #e MD. Jal"alva $aneuve $u"t al'ay" e avoi&e&.