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Neurological Physiotherapy A

We recommend reading the 'Clinical Assessment Resource Package' prior to viewing any videos. Download the 'Clinical Assessment Resource Package' from: http://www.appeducation.com.au/videos... 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