Post Concussion Syndrome Case Study: Following a Fall: Difference between revisions
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==== '''Objective''' ==== | ==== '''Objective''' ==== | ||
''Blood Pressure'' | '''''Blood Pressure''' - 108mmHg/66mmHg (within normal limits)'' | ||
''Heart Rate'' | '''''Heart Rate''' - 66bpm (within normal limits)'' | ||
''General Observation'' | '''''General Observation''' - no significant postural abnormalities'' | ||
''Gait'' | '''''Gait''' - normal'' | ||
''Speech'' | '''''Speech''' - normal speech comprehension and fluency'' | ||
''Upper Limb | '''''Upper Limb scan exam''' - normal'' | ||
'' | '''''Upper Limb Neurological exam''''' - dermatomes, myotomes & reflexes all normal | ||
'' | '''''Cranial Nerve Testing''' - normal'' | ||
''Palpation'' | '''''Cervical Active ROM''' - all ranges within normal limits'' | ||
'''''Superficial and Deep Neck Flexors''''' - activation and strength both normal | |||
'''''Palpation''' - increased tightness bilaterally in upper fibre trapezius and levator scapulae'' | |||
==== '''Outcome Measures''' ==== | ==== '''Outcome Measures''' ==== | ||
''Static Balance'' | ''Static Balance'' | ||
* | |||
''[[Functional Gait Assessment]]'' | ''[[Functional Gait Assessment]]'' | ||
* <u>Score</u>: 24/30, moderate impairment | |||
* Difficulty with gait with horizontal and vertical head turns category | |||
* Experienced increased dizziness | |||
''The Headache Impact Test'' | ''The Headache Impact Test'' | ||
* <u>Score</u>: 59, substantial impact on health related quality of life | |||
* Score range: 36-78 | |||
''Dizziness Handicap Inventory'' | ''Dizziness Handicap Inventory'' | ||
* <u>Score</u>: 45/96, moderate handicap | |||
* Physical, Emotional, Functional subscales | |||
''[https://physio-pedia.com/Vestibular/Oculomotor_Motor_Screening_(VOMS)_Assessment Vestibular-Ocular Screening (VOMS) Test]'' | ''[https://physio-pedia.com/Vestibular/Oculomotor_Motor_Screening_(VOMS)_Assessment Vestibular-Ocular Screening (VOMS) Test]'' | ||
Revision as of 03:06, 12 May 2020
Abstract[edit | edit source]
Introduction[edit | edit source]
Client Characteristics[edit | edit source]
Examination Findings[edit | edit source]
Subjective[edit | edit source]
History of Present Illness
Past Medical History
Symptoms
Medications
Health Habits
Social History
Current Level of Function
Objective[edit | edit source]
Blood Pressure - 108mmHg/66mmHg (within normal limits)
Heart Rate - 66bpm (within normal limits)
General Observation - no significant postural abnormalities
Gait - normal
Speech - normal speech comprehension and fluency
Upper Limb scan exam - normal
Upper Limb Neurological exam - dermatomes, myotomes & reflexes all normal
Cranial Nerve Testing - normal
Cervical Active ROM - all ranges within normal limits
Superficial and Deep Neck Flexors - activation and strength both normal
Palpation - increased tightness bilaterally in upper fibre trapezius and levator scapulae
Outcome Measures[edit | edit source]
Static Balance
- Score: 24/30, moderate impairment
- Difficulty with gait with horizontal and vertical head turns category
- Experienced increased dizziness
The Headache Impact Test
- Score: 59, substantial impact on health related quality of life
- Score range: 36-78
Dizziness Handicap Inventory
- Score: 45/96, moderate handicap
- Physical, Emotional, Functional subscales
Vestibular-Ocular Screening (VOMS) Test
Clinical Impression[edit | edit source]
Diagnosis: 36 year-old female presenting with post concussion syndrome two weeks after diagnosis of concussion from fall while ice skating on Jan 2, 2020. Patient has bilateral tightness in upper trapezius and levator scapulae, impaired bilateral single leg stance with eyes closed, and gait impacted by vertical and horizontal head turns. Symptoms are interfering with return to work, driving at night, getting a restful sleep, and grocery shopping. Patient is an excellent candidate for physiotherapy.
Problem List[edit | edit source]
- Disturbance in quality of sleep (unable to sleep straight through the night)
- Inability to drive at night due to light sensitivity
- Experiencing dizziness with dual tasks when walking and impacting performance in ADLs
- Unable to return to work due to symptoms from post concussion syndrome
- Tightness bilaterally in upper fibre traps and levator scapula
- Impaired single leg stance with eyes closed
- Gait impacted with vertical and horizontal head turns
- Headaches impacting health related quality of life
- Headache with all tasks on the VOMS
- Vestibular ocular reflex horizontal and vertical elicits dizziness and nausea along with headache
- Mild dizziness during visual motion sensitivity test
- Increase in pain when performing activities with head movements
Intervention[edit | edit source]
Goals[edit | edit source]
Education[edit | edit source]
Manual Therapy[edit | edit source]
Exercise[edit | edit source]
Balance
Stretching
Vestibular-ocular Reflex Specific Exercise
Outcome[edit | edit source]
Status Change Post Intervention[edit | edit source]
Outcome Measures[edit | edit source]
Discharge Plan[edit | edit source]
Discussion[edit | edit source]
Self Study Questions[edit | edit source]
The consequences of concussions can include which of the following?
- Physical
- Cognitive
- Emotional
- All of the above
Post concussion symptoms typically resolve in _________ days in adults.
- 4-6
- 7-10
- 15-20
- 10-12
The vestibular oculomotor screening test (VOMS) test the following?
- Convergence
- Smooth pursuits
- Visual motion sensitivity
- a and b
- a and c
- a, b, and c
- ↑ {{Template:The copyright holder allows this work to be used for non-commercial and/or educational purposes}}