Biomedical Engineering Reference
In-Depth Information
a two-person assist. AB was then able to sit up in his wheelchair chair for approximately
1 h. His alpha FIM score was 7.
AB spent the next 19 days in acute care where the OT saw the patient 4-5 times per week
and worked on his sitting balance, transfers, upper extremity training, and his grooming
tasks. Upon arrival to the tertiary rehabilitation facility, AB seemed withdrawn and had
limited eye contact with staff. Furthermore, he only answered questions put to him when
staff offered a large amount of encouragement.
11.5.2.2 Current Status
Within the next 3 weeks AB will be discharged to home from rehabilitation, and his cur-
rent status is thus:
•
Person:
•
Cognition:
AB is able to follow simple verbal commands and say some words
accurately, although his speech remained mostly incomprehensible. He uses
a lot of nonverbal language to get his message across. Because of his dif-
ficulties with language it has been difficult to fully assess all aspects of his
cognition. The OT has observed that there may be difficulties with his execu-
tive functioning but has so far been unable to determine the extent of these
difficulties.
•
Emotional:
AB finds his difficulties with communication extremely frustrating.
This has resulted in him lashing out at staff, his wife, and his children. This
frustration has limited his progress in rehabilitation because he often finds it
difficult to remain engaged in therapy tasks. AB has a supportive family and
this has helped his progress in rehabilitation. His wife visited most days dur-
ing his stay in rehabilitation. His children have also visited regularly, except
when restricted by work or family commitments. He has been very focused on
his discharge home, and at times he has used this as a motivator to continue to
work toward his therapy goals.
•
Physical:
AB continues to have a right facial droop. Because he failed his
swallow assessment in acute care he has had a percutaneous endoscopic
gastrostomy (PEG) tube inserted. Assessment revealed that AB does have a
left visual field cut. His arm improved to a Chedoke score of arm = 4 and
hand = 2. He started to develop tone in his right side and was seen daily by
the therapist assistant for passive range of motion (PROM). His leg improved
to a Chedoke score of leg = 4 and foot = 1. AB is now able to sit unsupported,
but when displaced out of his base of support he loses his balance to the left.
On the unit AB can transfer using a sask-a-pole and one-person assist. Within
the therapy unit he is able to undertake various transfers with a one-person
assist. He is now able to walk 3 × 5 m in the parallel bars using an AFO and
assistance from the PT. Daily he is able to sit in his wheelchair for most of
the day, taking a nap after lunch and before the 3:00 p.m. therapy session.
He attends a 30-min exercise class with the therapy assistant in the morning,
a 30- to 45-min therapy session with the OT in the morning, and a 30-min
session with the PT in the afternoon. There was no therapy coverage on the
weekends.
