1 / 12

Case Study 7

Case Study 7. Meredith Wahl and Anne-Marie Cecala. Examination. Charles Smith 3 y/o boy 2 parents Attends pre-school. Physical Examination. Lethargic, easily fatigued Not as energetic Ataxic gait Nausea/Vomiting Headache. Exam Continued. Strength ROM Sensation All WNL

keiki
Download Presentation

Case Study 7

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Case Study 7 Meredith Wahl and Anne-Marie Cecala

  2. Examination • Charles Smith • 3 y/o boy • 2 parents • Attends pre-school

  3. Physical Examination • Lethargic, easily fatigued • Not as energetic • Ataxic gait • Nausea/Vomiting • Headache

  4. Exam Continued • Strength • ROM • Sensation All WNL • All cranial nn intact • All reflexes normal

  5. Berg Balance Scale Total Score = 30/56 • 7. Standing with feet together (3) • 8. Tandem standing (2) • 9. Standing on one leg (1) • 10. Turning trunk-feet fixed (2) • 11. Retrieving obj from floor (2) • 12. Turning 360 degrees (2) • 13. Stool stepping (1) • 14. Reaching forward while standing (2) • Balance FeatureScore (0-4) • 1. Sitting unsupported (3) • 2. Change of position: sitting to standing (2) • 3. Change of position: standing to sitting (3) • 4. Transfers (1) • 5. Standing unsupported (4) • 6. Standing with eyes closed (3)

  6. Pathology • Medulloblastoma • One of the most common brain tumors in children • Usually forms in the cerebellum • AKA Primitive Neuroectodermal Tumor (PNET) • Usu found by CT scan or MRI • Actual dx only by BRAIN SURGERY • Remove skull • Sample tissue (wait for pathology results) • Remove as much as possible

  7. Prognosis • Depends on age of child when tumor found, location, amount remaining after surgery, metastasis, new diagnosis or recurrent • Prognosis for our patient is good. • Older than 2 yrs • 5 yr survival rate of 65-80%

  8. Disablement Model • Pathology – medulloblastoma • Impairment – decreased balance and coordination, fatigue, vomiting • Functional limitation- pt unable to sustain long periods of activity, unable to walk w/out assistance • Disability- cannot play with other children at school, cannot interact with parents at home

  9. PT Goals • LTG: In 2 wks pt to amb on even/uneven surfaces x 100 ft w/out assist to return to school/play activities 3 x wk. • STG: pt to amb on level surface x 25 feet in 5 days • LTG: In 2 wks pt to maintain sitting balance in armless chair w/out assist for 30 min to eat at table with family 2 x day • STG: pt to sit upright for 15 min without assistance with < 4 LOB in 5 days.

  10. APTA Practice Pattern

  11. PT Intervention • Pt and caregiver education • Balance training • Endurance training • Gait training

  12. References • Goodman C, Boissonnault W, Fuller K. Pathology: Implications for the Physical Therapist . Pennsylvania: Saunders; 2003.

More Related