1) Farouk is a 27-year-old man who injured his left knee 5 days ago playing football and was diagnosed with an ACL sprain. He is struggling with mobility and activities of daily living. 2) The physiotherapist conducted a subjective assessment involving questions about Farouk's medical history, injury mechanism, symptoms, and goals. An objective assessment measured his knee range of motion. 3) The problem list prioritizes Farouk being able to walk unaided at 3 weeks, climb stairs at 4 weeks, return to work part-time at 8 weeks, and resume light exercise at 6 weeks. Further tests are recommended to confirm the ACL sprain diagnosis.

1. Introduction to
Physiotherapy
Assessment
Student no:

2. Introduction
This film will detail an MSK assessment on a knee.
Subjective assessment, objective assessment and a problem list with
outcome measures will be provided.
The patient is Farouk who is a 27-year-old man with an ACL injury sustained
during a game of football.

3. Subjective Assessment
Farouk is a 27-year-old man who injured his left knee 5 days ago.
 PC: Struggling with ADLs (pain), especially walking. Unable to do job and using crutches.
 VAS Pain scale, How painful is it at rest and when moving around? (Visual Analog Scale) – This can give us the patients opinion on their pain and is a useful starting point.
 SIN – Severity, irritability and nature (type of pain) – This is helpful because it will inform us on which objective assessment to use and any further treatment.
 Is there night pain? – This tells us if there is pain at rest
 HPC: Twisting knee and hearing a pop when playing football. Able to mobilise but couldn’t continue playing. Few hours later swollen but ice brought it down. Pain got worse, walking difficult so A&E next day. ACL sprain diagnosis, no surgery necessary,
physio suggested.
 Visual check – looking for swelling and gait (Stability issues?) – This can tell us about how the patient walks and if there is any underlying issues that is separate from the ACL injury.
 Can you tell me any more about how the injury happened?, What surface were you playing on? – The type of surface could affect the injury e.g. grass has more give than AstroTurf.
 Any pain in hip or ankle? – Checking the joints above and below the injury top ensure it is only the ACL affected.
 PMH: Previous left knee injury 2 years ago – Farouk thinks similar injury. Asthma.
 Details of previous injury? How did it happen and what was the diagnosis? – Get the patient to give you their version of events because we could learn something new about the injury.
 How long did your previous recovery take? – Vital that we know this because there could be a treatment that works better or there could be lasting damage to the knee.
 DH: Paracetamol as necessary, Ibuprofen, Salbutamol, Beclometasone (Can Nonsteroidal Anti-Inflammatory Drugs Be Used in Adult Patients with Asthma?, 2020)
 What do you take ibuprofen for? – Asthma sufferers generally don’t take ibuprofen.
 Is your asthma under control? – Key information as patients' recovery could be affected by this.
 SH: Farouk lives with his friend in a first floor flat with one flight of stairs up to the front door. Works full time as a delivery driver. Farouk likes to go out with friends, go to the gym, and usually plays football twice a week, although he has had to stop doing
these activities.
 How are you finding the stairs? Is there a lift in the building? – Would we need to look at different accommodation during recovery.
 Is the friend supporting you, any family or further support? – The patient will need support so this information can help us inform other members of the MDT.
 How long do you sit in your van for work?, What does your job entail? – The patient will need to return to work asap due to finances so this is important so we can organise the best course of treatment.
 Has anyone in your immediate family had any major health problems? – This helps to inform us of any red flags such as cancer or diabetes.
 Any obvious bone deformities – Visual – Is there another diagnosis? Visually observing a patient can tell us a lot about an injury.

4. Objective Assessment
For the objective assessment I decided on passive movement of the knee in flexion to
extension and measured with a goniometer.
Consent was requested and PPE was worn to protect both the patient and myself. I
also ensured the bed was at the correct height. The hip should be kept at a 90o angle
throughout
I chose passive movement because the muscle feel is then removed, and the joint can
be felt better giving a good indicator of the state of the knee joint. Using passive
movement, I was able to assess for crepitus (Sounds and feels like abnormal popping
or crackling) which is a sign of arthritis or a previous injury.
I measured the knee at 40o full knee flexion for the model, with no knee problems. But
Farooq would be different due to injury.
Normal knee flexion is between 0-130o and normal walking gait is 67o flexion.

5. Problem List – SMART Targets
Problem (Priority Order) Outcome Measure Justification
ACL Injury – Unable to do Activities
of Daily Living (ADL) especially
walking
Patient to be able to walk 10
meters unaided without crutches
(10-meter walk test) 3 weeks post
injury
This is the most important as it will
enable the patient to do ADLs
independently.
First floor flat – Mobility issues with
stairs
Patient able to walk up one flight of
stairs unaided 4 weeks post injury
As the patient's flat is first floor the
next priority after walking must be
walking up stairs to enable the
patient to go home.
Unable to do Job– Injury prevents,
Reduced ROM
Patient able to return to work on a
part time basis 8 weeks post injury
– Measure ROM using goniometer,
improvement should be seen
The third priority must be the
patient getting back to work so that
they can earn money to live.
Unable to do social activities –
could affect mental health
Patient able to return to gym, light
exercise at first 6 weeks post injury
Finally, the fourth priority should be
activities to ensure the patients
mental health doesn’t suffer and

6. Conclusion
From completing this patients' assessment, I would want to have another
opinion and further tests to ensure the patient has an ACL sprain and
nothing more serious due to the inability to walk and carry out ADLs
independently.
I would also look at carrying out further objective assessment in the form of
palpation to check the knee joint and take more measurements to ensure I
know where the patient's recovery is starting from.

7. References
 Can nonsteroidal anti-inflammatory drugs be used in adult patients with
asthma? (2020, June 9). SPS - Specialist Pharmacy Service.
https://www.sps.nhs.uk/articles/can-nonsteroidal-anti-inflammatory-drugs-
be-used-in-adult-patients-with-asthma/
 Fruth, S. J. (2017). Fundamentals of the Physical Therapy Examination:
Patient Interview and Tests & Measures: Patient Interview and Tests &
Measures (2nd ed.). Jones & Bartlett Learning.
 MSD Manuals. (n.d.). Table: Normal Values for Range of Motion of Joints*.
MSD Manual Professional Edition. Retrieved 9 April 2021, from
https://www.msdmanuals.com/en-
gb/professional/multimedia/table/v1128315