Functional Assessment — Colleyville Chiropractic
Colleyville Chiropractic
Functional Assessment System
Functional Eval
PatientStanding SittingSupine PronePlan

Patient Information

Complete patient details before the functional assessment begins.

Patient Info
Chief Complaint
PHASE 1 — STANDING POSITION

Standing Assessment

Posture → Balance → Functional movement → Gait. Complete all while patient is standing/walking.

General Posture Observation
Static postural analysis — anterior, posterior & lateral views
Pending
Postural Findings — check all that apply
B1. Single Leg Standing Balance Test
Time until reaches out / hops / foot down / touches WB leg. Open ≥30s, Closed ≥10s = pass
Pending
B2. Trendelenburg Sign
Contralateral shoulder elevation / pelvic shift — glut med weakness indicator
Pending
B3. Lunge / Kneel Test
Lunge to kneeling and return without lumbar kyphosis
Pending
B4. Squat Coordination Test
Squat to 90° knee flexion without lumbar kyphosis; note soleus shortening
Pending
Gait Analysis
Observe walking pattern — identify deviations and underlying causes
Pending
Gait Deviations
PHASE 2 — SEATED POSITION

Seated Assessment

Patient seated — neurological screens, shoulder, cervical, and trunk tests.

Head / Neck Flexion Test
Deep cervical flexor endurance — SCM/suboccipital balance
Pending
Arm Abduction to 180° (Seated)
Scapular rhythm, trapezius balance, shoulder impingement screen
Pending
Seated SLR — Neutral Spine
Seated straight leg raise, lumbar in neutral lordosis
Pending
Seated SLR — Head Flexed
Differentiates neural tension from hamstring tightness (Slump test variant)
Pending
Trunk Flexion / Reflexion
Forward flexion reach — finger-to-floor distance, return asymmetry
Pending
PHASE 3 — SUPINE (FACE UP)

Supine Assessment

Patient lying face up — muscle length, hip tests, core strength, neurological.

Thomas Test — Hip Flexor Length
Supine: assess psoas and rectus femoris length; thigh-to-table relationship
Pending
Hamstring Length Test (Passive SLR)
Supine passive straight leg raise — ≥80° = normal
Pending
Adductor Length Test
Supine — bilateral hip adductor flexibility
Pending
Patrick FABER Test — Hip / SI Joint
Knee becomes parallel with table — hip restriction, SI, adductor tightness
Pending
Pelvic Tilt Test (Supine)
3 positions: A. Supine B. Legs extended out C. Legs extended up
Pending
Static ¼ Sit-Up Test (Timed)
Abdominal endurance — timed hold in seconds
Pending
Hip Flexion Strength Test (Supine Leg Hold)
Dr. elevates SL — patient holds. Core stability and hip flexor strength
Pending
PHASE 4 — PRONE (FACE DOWN)

Prone Assessment

Patient face down — posterior chain strength, muscle length, coordination.

Hip Extension Coordination / Strength
Prone: glut max firing pattern, lumbopelvic stability, hamstring dominance
Pending
Hip Abduction Coordination (Side-Lying)
Glut med, TFL, piriformis firing pattern during abduction
Pending
Nachlas Test — Rectus Femoris / SI
Prone knee flexion — RF length and SI/lumbosacral involvement
Pending
M/L Trapezius Test (Prone)
Middle/lower trap strength — scapular retraction and depression
Pending
Push-Up Plus Test
Serratus anterior strength — scapular protraction at end of push-up
Pending
Muscle Length Tests — Upper Quadrant
Upper trap, levator scapulae, pec major, pec minor, TFL, piriformis
Pending
Upper Trapezius
Levator Scapulae
Pectoralis Major / Minor
TFL / IT Band + Piriformis
Clinician Summary

Treatment Plan

Evidence-based program recommendations generated from your assessment findings.

Colleyville Chiropractic
Functional Assessment — Clinical Note
Assessment Report

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