This chart was prepared for Jane, Smith

John Doe Therapy

1234 Rehab Lane Suite B456
Therapy, Florida 33410

internal leg flexion 004	Sit on ball, both feet resting on ground, raise the right leg and cross it over the left with the right ankle touching the left leg above the knee. times/set sets times a day

Right lat bend 003	Sit on ball with knees bent, both feet resting on ground. Straighten one knee, and stretch toward the same knee while trying to touch the toes with both hand, while other leg remains still. times/set sets times a day

PROM shoulder extension 001	Patient Initial Position Doctor Position Patient Contact Doctor Contact Patient Movement Doctor Movement Pt Final Pos arm side hanging Squating Stance Distal arm full hand grasp shoulder extension Pull arm extented sitting back Homo lat Shoulder flat hand passive active sitting

PROM shoulder flexion 002	Patient Initial Position Doctor Position Patient Contact Doctor Contact Patient Movement Doctor Movement Pt Final Pos arm side hanging Square stance proximal forearm full hand grasp shoulder flexion Active LVHA arm up sitting back Homo lat Shoulder flat hand passive sitting

This technical chart has been created by DocuRehab Software - http://www.DocuRehab.com