PT 858: Charcot-Marie-Tooth Disease Case Study

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Abstract[edit | edit source]

Introduction[edit | edit source]

Client Characteristics[edit | edit source]

The patient is a 25-year-old male who is completing his Master of Science in Chemistry at a Canadian university in Ontario. He was diagnosed with X-linked CMT type 1A by a neurologist at the at of 14. The patient has had an increased amount of ankle sprains in the past 6 months, with the most recent one being around 3 weeks ago, in addition to general pain on the dorsum of the foot, and self-referred to physiotherapy for treatment.

Examination Findings[edit | edit source]

Subjective[edit | edit source]

History of Present Illness

Past Medical History

Medications

Health Habits

Family History

Social History

Functional History

Current Functional Status

Objective[edit | edit source]

Observation

-       Mild (R) mid-thoracic scoliosis

-       UE muscle tone appears normal

-       Bilateral pes cavus, more extreme arch of (R) foot, varus heel angle from posterior POV

-       Bilateral hammer toes

-       Distal mild muscle wasting of bilateral lower legs, stork inverted champagne bottle appearance notable on anterio-lateral leg

Range of Motion

Upper Extremity - All joints within normal limits for passive and active range

Lower Extremity - Hip extension: 14 degrees (R), 16 degrees (L); Ankle Dorsiflexion: 5 degrees (R), 6 degrees (L)

***all end feels normal

Manual Muscle Testing

Grade   /5  (R) Grade   /5  (L)
Hip Extension 4+ 4+
Hip Flexion 4 4
Knee Extension 5 5
Knee Flexion 4+ 5
Ankle Dorsiflexion 3 3+
Ankle Plantar Flexion 4 4
Ankle Inversion 3+ 3+
Ankle Eversion 5 5
Depiction of Pes Cavus.jpg

Neurological Assessment

Superficial Sensations

Light touch  

Pinprick

Deep Sensations

Proprioception

Vibration

Upper Motor Neuron Reflexes

Vitals

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Range of Motion

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Observational Gait Analysis

Outcome Measures

Clinical Impression[edit | edit source]

Analysis[edit | edit source]

Prognosis[edit | edit source]

Problem List[edit | edit source]

Intervention[edit | edit source]

Patient-centered Treatment Goals[edit | edit source]

Management Program[edit | edit source]

Outcome[edit | edit source]

Discussion[edit | edit source]

Self-Study Questions[edit | edit source]

Additional Patient Resources[edit | edit source]

References[edit | edit source]