07/12/2024
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A 32 year old professor of French language presented in the clinic https://www.facebook.com/Dr.irfanphysiotherapycenter with 06 month history of hypertension and diabetes as diagnosis
Status_post_acute CVA (cerebrovascular Accident)
It is important to undertake a through assessment involving questions and physical tests to determine the best way to treat a problem.
When we started taking his history, after observation we found something as described.
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✅Alert, oriented, and speech normal.
✅Sensation normal in both uper and lower limbs.
✅No neglect of the right side of the body.
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✅Muscle tone present in shoulder flexors, forearm pronators, and wrist flexors.
✅No active wrist extension, grip is non functional.
✅Partial active movement in shoulder and elbow.
✅Wearing a functional wrist splint.
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✅Walks independently but with poor posture
Increased right hip flexion and circumduction during the swing phase of gait.
✅Medication, increase Baclofen to 5mg at bedtime.
I discussed the presentation with the patient to ensure he had a good understanding of the problem and he likely outcome of treatment.
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✅ We use some therapeutic procedures for shoulder pain and low back pain , use NSAIDs, physical therapy modalities (e.g., , ).
I performed physiotherapy for the right upper and lower limbs to improve range of motion, strength, and gait training.
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✅To reduce stiffness and improve flexibility in the shoulder, elbow, and wrist.
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✅Use functional wrist splints during therapy to assist in gripping and hand function.
( ): ✅To stimulate wrist extensors and improve grip strength.
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✅ To improve motor control and reduce neglect of the right side.
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✅Focus on improving posture and correcting hip circumduction during the swing phase.
✅Train with assistive devices (e.g., AFO and tripod/single-point cane).
✅Use treadmill-based training with body weight support if possible.
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✅Focus on hip flexors, extensors, and ankle dorsiflexors.
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✅Static and dynamic balance exercises to reduce fall risk (e.g., standing on foam, single-leg stance).
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✅Activities like stair climbing, sit-to-stand, and functional movements to restore confidence in daily activities.
Provide counseling or therapy if the patient shows signs of frustration, anxiety, or depression related to delayed recovery.
This combination of treatments aims to enhance the patient's functional independence and quality of life. Let me know if you'd like further details on any of these approaches!
It is important to identify and address the underlying problems as well as treating the symptoms that present in the clinic to bring about long term solution to problems.
