Ficha Avaliacao Modelo Orto

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FICHA DE AVALIAÇÃO EM ORTOPEDIA 
Nome do paciente: __________________________________________________________________ 
Profissão: _________________________________________________________________________ 
Contato: __________________________________ data nascimento: ____/____/____ 
Diagnóstico médico: __________________________________________________________________ 
 
HMA / Queixa principal/ Relatos sobre a dor ( Nome, idade, profissão...) 
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Exame Físico: 
 
• Inspeção (alterações relevantes): 
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• Goniometria: 
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• Força muscular: 
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• Encurtamentos musculares: 
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• Testes especiais: 
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• Avaliação dinâmica: 
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Hipótese diagnóstica (Classificação Brasileira de Diagnósticos Fisioterapêuticos (CBDF) 
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Objetivos com o tratamento: 
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Conduta: (eletrotermofototerapia/parâmetros; fortalecimentos (CCA; CCF; séries, repetições; teste carga max); 
alongamento (tempo, séries); mobilizações; exercícios funcionais etc) 
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Exames complementares: 
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Obs: 
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Nome e RA do aluno (a) responsável pelo atendimento: 
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Correções Necessárias: 
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