Submit STAK Results - STAK Knee Stretcher

First Name*

Last Name*

Phone*

Email*

Hospital Physio Email

Position*

Employer*

Performance Rating

Please fill in the fields below to help us understand more about the effectiveness of the STAK tool when working with clients.

Start Date*

End Date*

Range of Movement (Degrees)

Flexion ROM Pre STAK

Flexion ROM Post STAK

Extension ROM Pre STAK

Extension ROM Post STAK

Patient Knee Surgery Information

Name of knee injury / surgery*

Time since surgery*

Manipulation under anaesthetic?*

Manipulation Date*

Score Data

Oxford Knee Score Start

Oxford Knee Score End

EQ-5D value pre STAK

EQ-5D score post STAK

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