[wp_objects_pdf] Patient Dashboard Symvetra User:
Patient ID:
Patient Name:
DATE:
Clinical Goals
Short Term (1-6 weeks)
* reduce spinal joint inflammation and muscle guarding
* promote tissue healing with recommended support modalities
* reduce pain by 25% within the first ten treatments
* begin restoring structural and functional deficiencies of the spinal pelvic system
* begin restoring losses of daily living and or work activities
* soft tissue rehabilitation
Long Term (3-6 months)
* return activities of daily living to fullest potential
* continued soft tissue conditioning to assist therapeutic interventions
* home care management to maintain therapeutic results and prevent deconditioning
X-RAY Digitization’s Completed
PRESCRIPTION: Interferential Electrical Therapy combined with Cryotherapy
Clinical Goals:
Reduce inflammation, muscle guarding, muscle spasm, promote tissue healing, pain relief.
Background:
Interferential electrical therapy is a standard of care to reduce inflammation, promote tissue healing and provide pain relief. Two different electrical frequencies are used on separate two pad channels. The pads for each channel are placed in opposing diagonal positions. When the two frequencies interfere a therapeutic frequency is formed.
Indications for Use:
Pain, muscle spasm, muscle guarding, inflammation.
Directions for Use:
Four electrical conductive pads are attached to the patient surrounding the center of the pain. The current is applied until the patient feels a slight tingling sensation. The current is increased until the tingling feels heavy but always to patient comfort and below the threshold of muscle contraction.
Cryotherapy is applied concomitantly to reduce inflammation and work as a local analgesic.
Location of Treatment
Affected Areas: ________________
Frequency:
____ initial ten treatments , ____ continue with spinal treatment.
Duration: 15 minutes.
This procedure is prescribed as medically necessary for the patient given the diagnosis.
__________________________
Attending Chiropractic Physician
PRESCRIPTION: Intermittent Longitudinal Traction
Clinical Goals:
Disc decompression to relieve pressure on lumbar and or cervical nerve roots and surrounding tissue.
Background:
Intermittent longitudinal traction is used to facilitate decompression of the spine. Decompression elongates the spine and separates the posterior vertebral joints and anterior discs. This procedure decreases interdiscal pressure and stimulates remodeling of the surrounding ligament structures.
Indications for Use:
Spinal stenosis, degenerative disc disease, disc bulge, disc herniation.
Directions for Use:
The patient is placed on their back. Vertical pins are placed at the top of the hips to fix the movement of the pelvis. The knees are raised to a 90 degree angle. The traction table when activated is pulled caudal against a resistive force. When the pull is released the resistive force pulls the table back to its original position where it suddenly stops. At the stop phase the patient’s torso suddenly accelerates cephalid. With the hips fixed the torso provides instantaneous inertial traction and disc decompression.
Location of treatment:
Lumbar, thoracic and cervical spinal regions simultaneously.
Frequency:
____ initial twenty treatments, ____ continue with spinal treatment.
This procedure is prescribed as medically necessary for the patient given the diagnosis.
_________________________________________
Attending Chiropractic Physician
PRESCRIPTION: Intersegmental Traction
Clinical Goals:
Improve the intersegmental, regional and global motions of the spine. Reduce muscle guarding by introducing repetitive flexion extension of the spine and pelvis.
Background:
Repetitive flexion extension of the spine in a cyclical fashion reduces muscle guarding while increasing segmental, regional and global motions. Flexion extension of the spinal joints reduces fixations while encouraging normal ranges of motion.
Indications for Use:
Loss of intersegmental motion, muscle guarding, ligamentous adhesions.
Directions for Use:
Patient is places on a flexion extension table in the supine position. The table is equipped with a rotating circular wheel with multiple rollers. The wheel is attached to a trolley that moves caudal to cephalid within a settable range. The wheel is adjusted to provide a variable vertical height of flexion and extension to the patient tolerance.
Location of treatment:
Lumbar, thoracic and cervical regions concomitantly.
Frequency:
____ initial twenty treatments, ____ continue with spinal treatment.
This procedure is prescribed as medically necessary for the patient given the diagnosis.
_________________________________________
Attending Chiropractic Physician
PRESCRIPTION: Pulsed Axial Traction
Clinical Goals:
Disc decompression to relieve pressure on lumbar nerve roots and surrounding tissue.
Background:
Pulsed axial traction using the DRX9000 is used to decompress the spine. Decompression elongates the spine and separates the posterior vertebral joints and anterior discs. This procedure decreases interdiscal pressure and stimulates remodeling of the surrounding ligament structures.
Indications for Use:
Spinal stenosis, degenerative disc disease, disc bulge, disc herniation.
Directions for Use:
The patient is placed on their back. A corset is placed around the chest and fixed to the table. This provides a point of stabilization. A second corset is placed around the lumbar spine and pelvis. This corset is attached to a tension strap which is computer controlled. A cyclical load / unload sequence is applied through the tensioning strap. The usual load is 50% of the patient body weight. The load is applied for 90 seconds and then released to a 50% value for 45 seconds. A series of twelve to eighteen load / unload cycles are applied during each treatment session. Treatment time is 20 to 29 minutes. Over the sequence of treatments, the load is gradually increased to 100% of the patient body weight.
Location of treatment:
Lumbar spine.
Frequency:
____ initial twenty treatments, ____ continue with spinal treatment.
This procedure is prescribed as medically necessary for the patient given the diagnosis.
_________________________________________
Attending Chiropractic Physician
PRESCRIPTION: Pulsed and Super Pulsed Laser
Clinical Goals:
Promote tissue healing, diminish swelling and inflammation, pain management.
Background:
Laser Therapy is the application of narrow width light over injuries or lesions to stimulate healing within those tissues. It is now popularly referred to as low level laser therapy (LLLT) and photo-biomodulation. Certain wavelengths are known to produce biostimulation that increases cellular ATP. Tissue response is dependent on the laser light reaching the target tissue. For other than surface wounds depth of penetration is dependent on the power of the laser. Pulsing of the laser is necessary to achieve sufficient depth of penetration without causing excess heat and tissue destruction. Power of the laser is measured in milli-watts per centimeter squared and 1000 milli-watts is equivalent to one Joule.
Indications for Use:
Pain relief; resolve inflammation; increase the speed, quality and tensile strength of tissue repair; stimulate the immune system; resolve infection; improve the function of damaged neurological tissue.
Directions for Use:
The laser is positioned on the surface of the skin and directed to the target tissue.
Specifications:
Laser frequency 904 nanometers, pulse rate 2-60 khz, time 4 minutes, joules 296 minimum.
Location of treatment:
_______________________
Frequency:
____ initial ten treatments, ____ continue with spinal treatment.
This procedure is prescribed as medically necessary for the patient given the diagnosis.
_________________________________________
Attending Chiropractic Physician
PRESCRIPTION: Dynamic Cervical Traction Using Radial Loading
Clinical Goals:
Diminish pain and improve function of the cervical spine by restoring normal cervical curve.
Background:
The POSTURE PUMP is a self contained poly resin frame and pneumatic unit that provides expanding ellipsoidal decompression. It is used to correct the normal biomechanical alignment and function of the cervical spine.
Indications for Use:
Disc bulge, disc herniation, reversed cervical curve, anterior head posture, chronic strain and sprain, cervicogenic pain.
Directions for Use:
The patient places their neck over a supported fulcrum which has an air bladder attached to its upper surface. The head and neck are stabilized over the fulcrum with the use of Velcro straps. The air bladder is inflated with a hand pumping device. With the head positioned over the fulcrum, and the head and neck fixed the bladder is inflated resulting in a radial force which pushes the cervical spine into lordosis. This improves vertebral alignment, increases disc height and improves cervical lordosis. The air bladder is inflated and held for ten seconds and then the bladder is deflated. This is repeated 12 times. The air bladder is then inflated and maintained for 12 minutes.
Location of treatment:
Cervical spine
Frequency:
Concurrent with spinal adjusting.
Duration:
Initial 7 weeks.
This procedure is prescribed as medically necessary for the patient given the diagnosis.
_________________________________________
Attending Chiropractic Physician
PRESCRIPTION: Exercise Rehabilitation
Clinical Goals:
Improve flexibility and strength of the ligaments and muscles of the spinal pelvic system. Strengthen specific muscle groups to assist in changing abnormal spinal distortions and prevention of future injuries.
Background:
Deconditioning of the muscle system is typically associated with spinal distortion resulting in acute and chronic soft tissue injuries which contribute to chronic pain syndromes. When an abnormal spinal distortion persists the ligaments remodel from their symmetrical attachments. This remodeling resists further spinal deterioration but also prevents normal joint function and symmetry of motion. Overload, fatigue and imbalance of the muscle system results as spinal imbalances activate prime movers to maintain an upright neutral posture.
Stretching precedes resistance exercises to safely prepare the spinal joints for loading. Each prescribed exercise is accomplished using the Zinovieff technique. This technique allows the patient to safely exercise by starting at a resistance level at 50% of an anticipated maximum lift.
Indications for Use:
When deconditioning and abnormal spinal distortion is identified specific muscle groups are used as effective levers to reestablish normal coupling patterns.
Directions for Use:
The patient is instructed which muscle group/s is or are to be rehabilitated using specific resistance training equipment. The Zinovieff technique involves performing three sets of ten repetitions. The attending physician determines the initial starting weight which is approximated to be 50% of a maximum lift. The first set of ten is performed at the initial starting weight. An attempt is made to lift an eleventh repetition. If an eleventh repletion is accomplished then the weight is increased at the next treatment session by one standard unit or the next plate setting on the machine. The second set of ten repetitions is performed at 75% of the first lift. The third set of ten repetitions is set at 50% of the first lift. In this manner the patient is challenged on strength, endurance and range of motion.
Location of Treatment:
Eee Rehabilitation Worksheet for determination of specific muscle groups.
Duration:
Begin when determined to be reasonably safe to perform and continue with spinal treatment.
Comments:
_________________________________________________________________________________________
This procedure is prescribed as medically necessary for the patient given the diagnosis.
_________________________________________
Attending Chiropractic Physician
PRESCRIPTION: Whole Body Vibration Therapy
Diagnosis:
Diminished Balance and Equilibrium, Inappropriate or Diminished Proprioceptive Feedback.
Clinical Goals:
Improve balance, reinforce structural and functional changes by improving proprioceptive response. When the eyes are closed the righting reflexes are disrupted and emphasis for balance is placed on vestibular and proprioceptive inputs. A vibration plate stimulates proprioceptive input.
Background:
Vertical balance is maintained by righting reflexes that include a combination of inputs and feedback loops consisting of visual, vestibular and proprioceptive inputs processed by the central nervous system. These input systems share equal weighting when the spinal system is functionally efficient. When the spinal system becomes structurally and functionally compromised the visual system becomes dominant in maintaining balance.
Indications for Use:
When normal alignment, function and balance of the spinal system are disrupted vibration therapy stimulates rehabilitation of the righting reflex by exaggerating proprioceptive and vestibular input.
Directions for Use:
The patient stands on a vibration plate set at low amplitude (1.5 mm) and a frequency of 30 hz. The patient is supported in the upright posture with a vertical support. The patient is instructed to close their eyes and try to maintain balance. The typical reaction is swaggering left/right and forward/backwards. The patient tries to stabilize the upright position. When the upright position is stabilized the patient then rotates their head left and right trying to disrupt balance. If disruption is noted the head is returned to a neutral position and then re-entered into the destabilizing position. This is repeated until the destabilizing position is stabilized.
Advanced training includes:
(1) expanding cervical ranges of motion to include lateral flexion and flexion and extension, (2) torso lateral bending and rotation, (3) lumbar lateral bending and rotation, (4) repeat steps 1-3 with a one legged stance, (5) steps 1-4 without a vertical support.
Frequency:
Following spinal manipulation and rehabilitation.
Duration:
2-5 minutes.
This procedure is prescribed as medically necessary for the patient given the diagnosis.
_________________________________________
Attending Chiropractic Physician