Sample Case: Peripheral Nerve Injury

Px comes to you with a c/o weakness of (L) elbow flexors after holding the bag while doing her shopping. She also c/o numbness and paresthesia on the (L) lateral elbow that prompted her to see a Physiatrist.

The following also noted:

1. min weakness of (L) wrist flexors

2. (L) thumb numbness and paresthesia

3. (N) MMT of elbow extensors and wrist extensors

4. (N) ROM of all four extremities

5. inability to carry bags on the (L)

Give the following

1. MMT of any affected muscle above

2. Special Test to confirm px’s symptoms

3. DTR

Give the following Mx:

1. One electrotherapeutic agent

2. Four PT exercises

3. Two HI

Sample Case: Spinal Cord Injury

A T12-L1 Incomplete SCI patient is referred to your facility. Upon assessment, you noted the following manifestations:

1. Paralysis of (B) LE

2. Grade 5 muscle grade of (B) UE

3. Good Trunk Control

4. Good Sitting Balance/Tolerance

5. Can ambulate with the use KAFO and axillary crutches

6. Areflexia of (B) LE

7. Atonia of (B) LE

Perform:

1. Perform Sensory Testing of L2 (Write on your paper the procedure and the possible MMT grade)

2. Perform Special Test (Write the SPT with the procedure and response)

Perform:

1. w/c to bed transfer

2. floor to w/c transfer

3. Teach patient to go up and down the stairs

Sample Case: Cerebro Vascular Accident

A 58 yr old male patient with (L) MCA stroke 2 months status post has been admitted to your facility. Upon assessment, you noticed that the patient is already in GRADE 3 of Brunstromm Stage with the following manifestations:

1. Weak Ankle Dorsiflexor (R)

2. Trunk Control

3. Fair Standing Balance Tolerance

4. Can ambulate with the use of walker with moderate assist on the pelvis and shoulder

5. Grade 2 Spasticity on (R) UE and LE

6. Hyperreflexia on all tested parts

7. Slouched posture

With these manifestation, give the following:

1. Cranial Nerve Testing “direct and consensual reflex” (write on your paper the procedure and the response)

2. Sensory Testing “deep sensation”(write on your paper the procedure and the response)

Give (1) management in the following manifestations:

1. Exercise for posture (given the posture of the patient, PNF)

2. Exercise for ambulation(while the patient is ambulating)

Electromodality for grade 2 spasticity of (R) elbow flexor