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Lumbopelvic Scan Exam Checklist

Lumbopelvic Scan Exam Checklist


Monitor your patient's symptoms quickly and effectively with this lumbopelvic scan exam checklist. This checklist will help you consistently assess for symptoms that would assist in your clinical decision- making, and to keep an eye out for red flags.

Regardless of the number of specialist evaluations our patients who have pelvic dysfunction have completed, the pelvic rehabilitation provider must continuously look for “red flag” symptoms and complete screening for referral as appropriate. Many therapists forget this important step, or have good intentions towards completing crucial steps yet fail to return to intended screening. A screening test might include a lower extremity neurologic scan, or a bladder symptom screen. How can this clinical challenge be met with consistency and accuracy?

One of the first steps is to develop the habit of either completing a screen on the first visit (especially in the presence of suspicious symptoms) or of resuming the examination on the second treatment (or at any time that symptoms change and warrant a review.) The next step is in having a “checklist” or reminder so that you can quickly assess for symptoms that would assist in your clinical decision- making.

Herman & Wallace has created a 2-part product to meet this need. One part offers the checklist, and this is accompanied by a handout for therapists that guides you through the process of using the checklist.


This product contains the following:

1. Screening in Pelvic Rehab - a 5 page handout for therapists.
2. Lumbopelvic Screen Checklist - a 4 page checklist for screening of patients with pelvic dysfunction.
3. Checklist Notes to Therapists - a 7 page description with relevant information to guide the therapist through the screening.
These documents will be delivered in the format of Microsoft Word files.