Concepts of Neurological Rehabilitation
A case study/Essay on Concepts of Neurological Rehabilitation
4000 word count NO MORE
12, Times New Roman, Harvard
School of Health and Rehabilitation
Module Title: Concepts of Neurological Rehabilitation
ASSESSMENT:
Essay 4,000 words maximum Module Weighting 100%
All coursework must be submitted before 13:00 on 5th. Of December.
The student is supposed to be working critically at MASTERS LEVEL
TITLE: Critically discuss the management of one aspect of rehabilitation related the attached patient scenario.
Whilst the assignment may include a brief overview of the case as a whole, it is recommended that the student should concentrate on one aspect of the patient’s presentation or rehabilitation. Clear links should be made between theory and practice. A comprehensive and up to date critical review of the relevant literature or clinical guidelines should be presented in the assignment, reflecting back to the patient / case wherever possible.
Guidance:
The assignment should include a clear statement of its aims, appropriate explanation of any model and/or theory, appropriate and critical application of any model or theory relating to the management of the neurological problem, critical use of empirical studies to illustrate issues raised by the specific scenario. Where applicable you may draw on examples from your own clinical practice but avoid long descriptions: ensure that you are evaluative and place any such examples clearly in the context of your essay.
Weighting 100%
Case scenario:
Mrs Carpenter is 72 years old. She was admitted to a stroke rehabilitation unit 4 weeks ago with sudden onset of left hemiplegia following a right partial anterior circulation stroke (PACS) in the middle cerebral artery. She is due to be discharged home next week.
Social History:
Mrs Carpenter is a retired primary school teacher. She lives with her husband (who is fit and well) in a detached house with toilet and bathroom upstairs and downstairs. Mrs Carpenter’s hobbies include socialising with her friends and family, embroidery, travel, cooking, and walking the dog. She is right-handed. She stopped smoking 25 years ago.
Past medical history:
Cholecystectomy
Summary of objective assessment:
• Communication:
o No dysphasia, mild facial weakness but no dysarthria; reluctant to communicate or interact with staff, other patients, or family; lacking concentration; emotional and weepy; worried about the future
• General functional ability and mobility
o Able to transfer (bed ?? to chair, sit ?? stand etc) independently
o Balance – sitting balance good, but unsteady on weight transfer in standing
o Needs some help with dressing and personal care
o Independent eating and drinking using right hand, but poor appetite
o Able to walk 6m slowly with 1 stick and supervision / minimal assistance
o Fatigues quickly
• Left lower limb
o Full passive range of movement but some resistance to passive movement distally in left plantarflexors and long flexors of the foot and digits
o Lacks active / selective control of left hip and knee extension in standing
o Some loss of active dorsiflexion left leg when walking resulting in poor heel strike
• Left upper limb o Mild subluxation left shoulder with some stiffness and loss of external rotation in shoulder joint
o Weakness distally in upper limb; able to actively extend wrist up to 20 degrees and extend fingers up to 10 degrees beyond neutral; beginnings of prehension
o Loss of sensation, particularly proprioception, light touch, and tactile discrimination distally in hand.
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