Neurological Physiotherapy A
ฝัง
- เผยแพร่เมื่อ 26 ก.ค. 2015
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Background information for video vignette .
Diagnosis:
R MCA infarct with L Hemiplegia
Context of assessment:
The student has been requested to perform a ward based, functional assessment for a patient admitted to the ward today. It is expected that the patient will undergo a full neurological assessment the following day, therefore, the student has been instructed to adequately assess the patient to provide clear instruction for ward staff on the patients functional capability.
TABLE 1: Background information for neurological vignette
DEMOGRAPHIC INFORMATION
Setting:
Rehabilitation ward in hospital setting
Gender:
Female
Patient age:
60 ‐ 70
Cultural background:
Non English Speaking Background - limited English
Occupation:
Retired
Main Presentation:
R MCA with L Hemiplegia
Student Name:
Kate
Educator Name:
Peter
Patient Name:
Mrs Novak
CLINICAL HISTORY
Reason for attending physiotherapy:
Admitted to rehabilitation ward today after presenting to ED last night with L sided weakness and slurred speech.
History of presenting condition:
Patient collapsed while at home and transferred to local hospital ED. Diagnosed with thrombolytic R MCA infarct and managed with TPA therapy within 3 hours of symptom onset. Patient transferred to acute stroke unit for rehabilitation and is 1 day post infarct. Investigations CT - Infarct R MCA
Past Medical History:
Osteoporosis, OA bilateral knees
Past Surgical History:
Thyroidectomy 15 years ago, vein ligation and stripping 4 years ago, hysterectomy 10 years ago,
Medications:
Thyroxin, osteoeze, glucosamine
Alcohol and Drug:
Nil illicit drug and nil alcohol
Dominance:
R Hand Social
History:
Lives with supportive husband who is physically well. House has 13 internal stairs with rails on both sides. Living area downstairs bedroom upstairs but bedroom and bathroom also available downstairs.
Functional History:
Previously independently mobile with no aids and independent with all ADL’s. Exercise tolerance able to walk greater than 45 minutes on flat without concern Patient Goals To return home to live with husband; independent mobility
very good approach. very professional in her assessment, treatment and her commands.
A must to watch the video to learn how to interact with patients
I agree
Learning and gaining knowledge is useless if its not applied in real patients.
A student or a Physiotherapy doc who can apply max theoritcal knowledge in real clinical scenario would be the best Doctor
wow you discovered "l' acqua call"!!
Came because it showed up on my asmr recommendations but stayed awake because I just had to see how this poor lady did. The doctors were so good with her too I hope she made a full recovery bless her heart
It may be miss judge for people for watching this video..
Initial assessment show that lady has no muscular control on her arm and leg..
So after gaining control only you able to do this sitting assessment.
So do assessment stage wise with recovery..
Even she confirmed that there is no sence in her arm and leg so dont go blindly..
Although her command is very good..
Beautifully explained!!
This is amazing she’s very smart and professional and this will help me
The best thing I've watched so far
Thank you so much, smart asssesment and treatment
love d way you attend to patient
john unuigbe 9
Me too
I have borderline . Dr.said me it couldn't be increase .what the solution ..?
Was it me or did the patient gain mobility in her left leg from zero movement or feeling while laying down to lifting her entire hip and lower leg while sitting. Was that mistake from the patient actor or is that actually a possibility?
Yeah I think she forget. If she can't lift her leg up while in bed I don't believe she'd be able to sit bedside and move it against gravity.
I think it is actually possible
With distraction movements are possible. Have you heard of functional movement disorder? Don't think it was acting
Look at you, sherlock!!
omg that was such an amazing video it helped me a lot and she was a great PT student thanks a lot
Good luck mate
Great job
A lot of useful information!👍
There was a muscle flicker on the affected arm (left side) so the muscles grade there would be 1 not zero
said she could not feel flicker from left arm so that would be ZERO
The flicker appeared to be in the left shoulder flexors, not the elbow flexors which she was assessing when she graded as zero. (Although it appears each segment of the video is it's own entity, as deficits in earlier parts don't seem to necessarily carry over to later parts)
She is so good ❤️
What if the patient is blind? Can you give us some tips on how to motivate her during treatment.
Play her her favourite music
give as much as possible tactile and verbal feedback. Use our voice (loud when you want strenght, like PUSH PUSH PUSHHH MY HAND! COME ON COME ON! and guide the movements with your voice and hands. when you want trunk control..guide the patient..d o you feel you are falling to the right? correct yourself. do you feel your side muscle in your belly? do you feel my hand? contract that muscle. You have to do this with every patient but esp blind patients, because they cant see and their visual feedback from you and theirselves is absent. Your verbal feedback and what they have to feel must be more than with normal patients
Put on a blindfold so she'll feel better that you have something in common.
Thank you!!!
Great work 👍
Excellent work
Wow! this is very clear and so accurate...
how can i do this excercise in a day and plz tell me limit the time
Babu Bhai A
No limit
I like the way she treats
Same
Your vedios are informative 👍
I hope this works for my mom
When are you going to treat Casca? She didn't enjoyed pretty much what you did to her
😂
You are excellent madam
MY FATHER WAS ALSO STROKE PATIENT . HE WAS ONE SIDE PARALYSES, HE WAS NOT FULLY CONSCIOUS . NOW A DAYS HE IS NOT CONSCIOUS.WHAT SHOULD WE DO FOR HIM? I AM VERY TENSED FOR HIM. PLEASE ADVISE ME. ANY CHANCES TO COME SENSE?
🙏
Your father recovered
O my god thank you very much🥰🥰🥰
I have been following Dt Tara Tobias she is very good
very good student
👌🏼👌🏼👌🏼
Look for Neurological Physioteraphy I
Hi sir I am neuro surgery patient I can't spread my hand fingers and I can't walk without any supp or please give me some suggestion for cure my self AI am very disappointed with my condition 😭😭😭
Ang ganda. Pag ako, makakatayo agad.
nice to demo madam that vidios i love that im approach to how introducing yuore patients or clients madam we love that thats way you to how improve the patients madam how to applied us physiotherapist assistant we love that how to help the others peoples madam
great!!
Woo 👌🏼👌🏼
Ok
I am a Physician Assistance intrested in physiotherapy
i like this video
Very good
I'm new 😀
👌🏽
💪🏼👌🏼
मेरी माँ का हैडिंजुरी हुई है इस लिए वो 4 महीने से बोल नही पा रही है कृपया कोई व्यायाम बातये
👍🏼
খুব ভালো প্রসসে।
Physio therapy for back
Doesn’t seem very practical
In hindi
Gy
good
Awesome
Why so cringeworthy
I know haha
This student is very rude!
How so? She seems to stay very professional and supportive with her patient throughout the whole video.
If you get someone that nice at the hospital and someone that patient - you will be lucky :)
Shes tryinf her best i think
U are a fucking idiot how was she being rude dumb ass she just has a stroke what do u expect
Gy