Traumatic Brain Injury - Case Study Part 4

Presenting Condition

For background information go to

Traumatic Brain Injury - Case Study Part 1

Traumatic Brain Injury - Case Study Part 2

Traumatic Brain Injury - Case Study Part 3

Assessment Update

18 Months Post Injury

	Upper Limb		Lower Limb
	Left	Right	Left	Right
Tone	Increased	NAD	Increased	NAD
Power	3/5	5-/5	3+/5 Ankle 3+/5 Hip 3/5 Knee	5-/5
Coordination	Impaired
Range of Movement Muscle Length	Shoulder: Flexion 110° Abd 90° IR 40° ER 55° Elbow: Full ROM Wrist: Full ROM	Shoulder: Full ROM Elbow: Full ROM Wrist: Full ROM	Hip: Full ROM Knee: Full ROM Ankle: Decreased ROM DF with Knee Ext 0°	Hip: Full ROM Knee: Full ROM Ankle: Decreased ROM DF with Knee Ext 5°
Sensation	Impaired
Proprioception	Unable to Assess
Reflexes	Increased	NAD	Increased Plantar - Upgoing	NAD Plantar  - Downgoing

Current Function

Independent Standing Transfer 


Supervision  of 1 with 1 Elbow Crutch & AFO for Mobility

• 6 Min Walk Test Complete
• Distance

Supervision of 1 on Stairs

• Up to 20 Steps
• Reciprocal Pattern Ascending
• 2 Feet to Step Descending with at least 1 Handrail 


Supervision of 1 on 6 Inch Curb 


Ultimate Goal: Return to Cycling

Discussion

Consider the role of physical activity for James in their current management. Considering his clinical condition what do you think are the benefits of exercise and what might limit the activities he can do? What advice or home exercises would you give James ? Go to Discussion