Rehabilitation Interventions Case Study
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History of Presenting Case[edit | edit source]
Alan is a 28 year old male. He uses a wheelchair for mobility, is independent in all transfers using standing transfers, and drives. Alan was seen by the National Wheelchair Rugby Team physiotherapist prior to full return to National Squad Training sessions, which had been suspended for 16 months as a result of COVID-19 and restrictions on indoor team based sports training. During the time away from National Training Alan had 2 major injuries.
- Fall from his Wheelchair which resulted in Complex Fractures of the Left Tibia and Fibula in five places including oblique displaced and comminuted fractures, which required removal and replacement of previous IM Nail, Plates and Screws, followed by 12 weeks in cast (8 weeks in full leg cast followed by 4 weeks in below knee cast.
- Right shoulder injury which occurred while blocking a pass during wheelchair rugby training at his club just at the beginning of the initial COVID-19 lockdown, which remained in place for 3 months. He felt a subluxation at the right shoulder with significant pain and had to stop playing. Rested for 1-2 weeks with ongoing pain prior to going for further assessment and MRI Scan, which showed a right labral tear. As a result of COVID-19 restrictions initial physiotherapist was conducted via telehealth.
Currently Alan was back at club based Wheelchair rugby and basketball training for 6 weeks but has not yet returned to full contact sport or competition. He is doing gym based strength training 3 times per week, cardiovascular training 1-2 times per week on Nordic skier and court based training in his sports chair 2-3 times per week focusing on pushing technique, endurance in chair, agility and just started some speed based training but is now having some intermittent shoulder pain.
Subjective Information[edit | edit source]
Medical History[edit | edit source]
Alan has Type 3 Osteogenesis Imperfecta and has had 105 long bone fractures (majority occurred during childhood and adolescents with decreased incidence in adulthood) including femurs, tibia, fibula, humerus, ulna and radius with intramedullary rods in all long bones, and multiple surgeries with plates and screws.
Sport Injuries[edit | edit source]
Leg Injuries
- Tibial Fracture - Left
Shoulder Injuries
- Rotator Cuff Tendonopathy
- Rotator Cuff Tears
- AC Joint Seperation
- Bursitis
Elbow Injuries
- Recurrent Lateral Epicondyle Tendonopathy - Right
- Bursitis
Wrist Injuries
- Sprains
- De Quervains Tenosynovitis
Fingers
- Sprains- Thumb & Multiple Fingers
- Finger Fractures
Work[edit | edit source]
Alan works as Strength and Conditioning Coach with a personal training company that promote physical and mental wellbeing and provide an alternative take on health and fitness, integrating quality movement training, professional coaching, and social get togethers as a way to promote physical and mental health, and community spirit. Community is at the heart of the company that he works with, and a big part of that is bringing people together outside of training sessions including regular long table lunch events, monthly book club meetings, and movie nights every now and again.
Sport[edit | edit source]
Alan plays Wheelchair Basketball at club level and is an Irish International Player for Wheelchair Rugby.
Goal[edit | edit source]
- Return to Full Training including full contact
- Throw Ball Full Court
- Decrease Shuttle Test Time
- Descrease 5 min sprint time
- Decrease Agility Time
- Selection for National Team for European Championship in 6 months
Objective Assessment[edit | edit source]
Range of Movement and Strength[edit | edit source]
| Range of Movement | Strength | |||
|---|---|---|---|---|
| Right | Left | Right | Left | |
| Shoulder Flexion | 95 | 110 | 5- | 5 |
| Shoulder Extension | 30 | 45 | 5- | 5 |
| Shoulder Abduction | 100 | 110 | 5 | 5 |
| Shoulder External Rotation | 50 | 80 | 4+ | 5 |
| Elbow Extension | -45 flexion | -40 flexion | 5 | 5 |
| Knee Flexion | 120 | 135 | 5 | 5- |
| Knee Extension | +5 hyperextension | 0 | 5 | 5- |
| Ankle Dorsiflexion | 25 | 10 | 5 | 5 |
On Court Testing[edit | edit source]
| Personal Best | Current | |
|---|---|---|
| 12 Min Push | 52 Laps | 41.5 Laps |
| 5m Sprint | 2.57 seconds | 3.12 seconds |
| 10m Sprint | 3.79 seconds | 4.9 seconds |
| Agility | 13.96 seconds | 15.81 seconds |
| Throw - Timed 1 min | 206 | 182 |
| Throw - Distance | 26.5 meters | 21.08 meters |
References [edit | edit source]
- ↑ Aclai. All ages and abilities training at ACLAÍ. Available from: https://youtu.be/K0oGOfxaez0[last accessed 30/10/17]
- ↑ Aclai. Alan Dineen Training Montage. Available from: https://youtu.be/zXY2_w1ymRM[last accessed 30/10/17]
- ↑ Paralympic Games. Paralympic Sports A - Z; Wheelchair Rugby. Available from: https://youtu.be/tSzFmlWgVsM [last accessed 30/08/2021]
- ↑ Irish Wheelchair Association - Sport. Achieving Greatness - Alan's Story. Available from: https://youtu.be/ba9SKRd7uuM[last accessed 30/08/2021]
