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PT PRESCRIPTION
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Diagnosis
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Other Diagnosis
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Status Post Sx?
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Type of Surgery
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Date of Surgery/Injury
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Frequency
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Insurance
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Body Parts to Include
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Protocol
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Level
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No neck extension past neutral
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Cervical rotation and flexion ok Isometric neck, trunk and core stabilization
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Postural training/periscapular stabilization - encourage upright posture at ALL times, standing erect, shoulders/scapulae held posterior, exaggerate lordosis
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No forceful bending at the hips past 90 degrees; no forceful twisting; no lifting greater than 10 lbs from the floor
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Avoid any flexion stretching/ROM; encourage only extension/lordosis, avoid painful movements
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Minimal stretching/ROM, only through the pain-free arc of motion
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Minimal neck stretching/ROM, flexion and rotation only (NO neck extension past neutral), only through the pain-free arc of motion
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Gentle progressive ROM as tolerated, through pain-free arc of motion
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Unrestricted activity if patient has full ROM
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Postural training/periscapular stabilization
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Isometric trunk and core stabilization
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Modalities PRN
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Scar tissue mobilization/massage
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Nerve glide stretches if radiculopathy/needed
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Gate/Balance/Proprioception Training
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CV conditioning
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HEP
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Avoid pressure on the wound, do not place gait belt over the wound
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Other/ Notes
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Acupuncture
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Chiropractor
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Physician Information (Bhamb)
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