Start
Low tone
High tone
Reduced range of
Reduced
Reduced
Shoulder
Shoulder
Poor rolling
Poor pelvic
A.O.1 Bed 
A.O.2 Bed 
A.O.1 Sit 
A.O.2 Sit 
Standing hoist 
Poor standing
Supervised 
Wheelchair 
Poor stepping home | anatomy | physiology | pathology | clinical guides
1 Has the person had an acute stroke within last 24 hours? Any of these present: face droop, slurred speech, one sided numbness?
2
2 Has the patient been cleared by a medical team for assessment?
3
3 Can the patient move their right leg and arm without issues?
4
4 Is the right leg or arm stiff to move in one direction?
Right Hemiplegia increased tone
3 Can the patient move their right leg and arm without issues?
4
4 Is the right leg or arm stiff to move in one direction?
8
8 Is their left leg or arm heavy and floppy?
Next
Right Hemiplegia low tone
4 Is the right leg or arm stiff to move in one direction?
6
6 Can the patient move their left leg and arm without issues?
7
7 Is their left leg or arm stiff to move in one direction?
Left Hemiplegia increased tone
1: Has the person had an acute stroke within last 24 hours? Any of these present: face droop, slurred speech, one sided numbness? No = go 2
2: Has the patient been cleared by a medical team for assessment? Yes = go 3
3: Can the patient move their right leg and arm without issues? Yes = go 6
6: Can the patient move their left leg and arm without issues? No = go 7
7: Is their left leg or arm stiff to move in one direction? No = go 8
8: Is their left leg or arm heavy and floppy? Yes = Left Hemiplegia low tone
Left Hemiplegia low tone treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? No = Poor sitting balance
Poor sitting balance treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? No = Reduced proprioception
Reduced proprioception treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? No = Reduced sensation
Reduced sensation treatment
9 Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem?
10
10 With their eyes closed can they feel the impaired limb being moved passively by another person?
11
11 With eyes closed, can they feel impaired limb being touched?
12
12 Can the affected shoulder be moved fully by another person?
13
Reduced range of movement
13 Does the shoulder look out of place?
14
14 Is the shoulder painful?
15
15 Can the affected elbow be fully straightened?
16
Elbow contracture
16 Can the affected wrist be moved through full range?
17
Wrist contracture
17 Can the hand/fingers be fully opened?
18
Hand flexion contracture
18 Can the affected hip be moved fully through range?
19
Hip flexion
contracture
19 Can the knee be moved fully through range?
20
Knee
contracture
20 Can the ankle be moved fully through range?
Ankle
contracture
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? Yes = Shoulder subluxation
Shoulder subluxation treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? Yes = Shoulder pain
Shoulder pain treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? No = Elbow contracture
Elbow contracture treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? No = Wrist contracture
Wrist contracture treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? No = Hand flexion contracture
Hand flexion contracture treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? No = Hip contracture
Hip contracture treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Is the upper or lower limb stiff to move in one direction? Yes = go 19
19: Can the knee be moved fully through range? No = Knee contracture
Knee contracture treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? No = Ankle contracture
Ankle contracture treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? No = Poor rolling ability
Poor rolling ability treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? Yes = go 22
22: Can the patient lie on their back and lift their bottom? No = Poor pelvic tilting
Poor pelvic tilting treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? Yes = go 22
22: Can the patient lie on their back and lift their bottom? Yes = go 23
23: Can the patient move from lying to sitting unaided? No = go 24
24: Can the patient move from lying to sitting with assistance from one person? Yes = A.O.1 Bed transfers
A.O.1 Bed transfers treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? Yes = go 22
22: Can the patient lie on their back and lift their bottom? Yes = go 23
23: Can the patient move from lying to sitting unaided? No = go 24
24: Can the patient move from lying to sitting with assistance from one person? No = go 25
25: Can the patient move from lying to sitting with assistance of 2 people? No = Assistance of 2 with bed hoist
Assistance of 2 with bed hoist treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? Yes = go 22
22: Can the patient lie on their back and lift their bottom? Yes = go 23
23: Can the patient move from lying to sitting unaided? No = go 24
24: Can the patient move from lying to sitting with assistance from one person? No = go 25
25: Can the patient move from lying to sitting with assistance of 2 people? No = A.O.1 Sit to stand
A.O.1 Sit to stand treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? Yes = go 22
22: Can the patient lie on their back and lift their bottom? Yes = go 23
23: Can the patient move from lying to sitting unaided? Yes = go 26
26: Can the patient move from sit to stand unaided? No = go 27
27: Can the patient move from sit to stand with assistance of 1 person? For a stroke patient, sitting to standing is best achieved slowly with two people to begin with, as blood pressure needs monitoring No = go 28
28: Can the patient move from sit to stand with assistance of 2 people Yes = A.O.2 Sit to stand
A.O.2 Sit to stand treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? Yes = go 22
22: Can the patient lie on their back and lift their bottom? Yes = go 23
23: Can the patient move from lying to sitting unaided? Yes = go 26
26: Can the patient move from sit to stand unaided? No = go 27
27: Can the patient move from sit to stand with assistance of 1 person? For a stroke patient, sitting to standing is best achieved slowly with two people to begin with, as blood pressure needs monitoring No = go 28
28: Can the patient move from sit to stand with assistance of 2 people? No = Standing hoist transfer
Standing hoist transfer treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? Yes = go 22
22: Can the patient lie on their back and lift their bottom? Yes = go 23
23: Can the patient move from lying to sitting unaided? Yes = go 26
26: Can the patient move from sit to stand unaided? Yes = go 29
29: Can the patient stand and lean in all directions independently? No = Poor standing balance
Poor standing balance treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? Yes = go 22
22: Can the patient lie on their back and lift their bottom? Yes = go 23
23: Can the patient move from lying to sitting unaided? Yes = go 26
26: Can the patient move from sit to stand unaided? Yes = go 29
29: Can the patient stand and lean in all directions independently? Yes = go 30
30: Can the patient walk unaided? No = go 31
31: Can the patient walk with a stick/zimmer frame unaided? No = go 32
32: Can the patient walk with assistance of one or two people? Yes = Supervised mobility
Supervised mobility treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? Yes = go 22
22: Can the patient lie on their back and lift their bottom? Yes = go 23
23: Can the patient move from lying to sitting unaided? Yes = go 26
26: Can the patient move from sit to stand unaided? No = go 29
29: Can the patient stand and lean in all directions independently? No = go 30
30: Can the patient walk unaided? No = go 31
31: Can the patient walk with a stick/zimmer frame unaided? No = go 32
32: Can the patient walk with assistance of one or two people? No = Wheelchair mobility
Wheelchair mobility treatment
9: Can they sit unaided and lean in all directions (sideways/backwards/forwards) without problem? Yes = go 10
10: With their eyes closed can they feel the impaired limb being moved passively by another person? Yes = go 11
11: With eyes closed, can they feel impaired limb being touched? Yes = go 12
12: Can the affected shoulder be moved fully by another person? Yes = go 13
13: Does the shoulder look out of place? No = go 14
14: Is the shoulder painful? No = go 15
15: Can the affected elbow be fully straightened? Yes = go 16
16: Can the affected wrist be moved through full range? Yes = go 17
17: Can the hand/fingers be fully opened? Yes = go 18
18: Can the affected hip be moved fully through range? Yes = go 19
19: Can the knee be moved fully through range? Yes = go 20
20: Can the ankle be moved fully through range? Yes = go 21
21: Can the patient roll to the left and right on a bed? Yes = go 22
22: Can the patient lie on their back and lift their bottom? Yes = go 23
23: Can the patient move from lying to sitting unaided? Yes = go 26
26: Can the patient move from sit to stand unaided? Yes = go 29
29: Can the patient stand and lean in all directions independently? Yes = go 30
30: Can the patient walk unaided? Yes = go 33
33: Do they have an altered walking pattern (abnormal gait)? Yes = go 34
34: Can they stand on affected leg and step with other leg? No = Poor stepping ability
Poor stepping ability treatment
1 Has the patient been cleared by a doctor and ready for physio?
2 Is blood pressure within x - x2 and heart rate within y - y2?
3 (to come from Jess)?
