AVALIAÇÃO CINÉTICO FUNCIONAL DA COLUNA CERVICAL

Data da avaliação: ___/___/_____

Dados do paciente
Nome: ________________________________________________________________________
Data de nascimento: ___/___/_____ Idade: ____ anos
Telefone: ( ) ________________ Telefone de emergência: ( ) __________________
Membro inferior dominante: ( ) Direito ( ) Esquerdo
Membro inferior lesionado: ( ) Direito ( ) Esquerdo

Diagnóstico clínico: ______________________________________________________________

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Queixa Principal: ________________________________________________________________
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HMA: _________________________________________________________________________
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Escala Visual Numérica de dor:

Menor nível de dor no dia: _________________________________________________________

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Maior nível de dor no dia: __________________________________________________________
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Inspeção visual
Vista lateral

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Postura cruzada
Vista anterior

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Palpação
Estrutura Direito Esquerdo
Protuberância occipital externa

Linha nucal

Processos espinhosos

Processos articulares

Processos transversos

Esternocleidomastóideo

Trapézio superior

Maléolo lateral artéria

subclávia e plexo braquial
Trigger points

Amplitude de movimento
Goniometria
Movimento Ativa direito Passiva direito Ativa esquerdo Passiva esquerdo
Flexão ( 0 – 65°)

Extensão (0-50°)

Inclinação lateral
( 0 – 40°)
Rotação ( 0 – 55°)

Testes especiais
Testes
Compressão cervical
Distração cervical
Direito Esquerdo
Spurling
Insuficiência vertebro basilar
Teste de Adson
Teste de Ross
Compressão subclavicular
Compressão do peitoral maior
Teste de abdução do ombro

Diagnostico fisioterapêutico:
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Objetivos do tratamento:
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Plano de tratamento:
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Fisioterapeuta: