Neurological Physiotherapy A

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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