emad
07-04-2004, 09:38 PM
Bernard i suggest there is a category on the forum for case studies like that topic i have put clinical reasoning process
I have one case study now , really iam hesitated to put it also under the same topic , then for example as case stude 2 ,..... 3 ...4
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The case : Bladder & Bowel control could be improved through neural mobilisation.
An adult 17 years male , i have asked to assess in the public hospital ,He was hospitalesd in the university hospital for about 35 days , then returned back .
Past history
All papers i have read about the month before i assessed him , denote that patient was admitted to the hospital with fever , and now it is paraparesis.
Present history (objective)
I found
1) a case of paraparesis ,bed ridden patient , with no bed sores.
2) Hyperreflexia
3) + clonus of both lower limbs
4)sitting was unbalanced
5)i had not tried to test standing so
6)cough and breathing was difficulty
7)lumbar region was highly in temperature ,when i touched
8)from sitting , i asked the adult to flex neck :arrow: back pain
hypothesis#
I considered the case meningitis , inflammation of the spinal cord , result in upper motor neuron lesion .
First day treatment
1)breathing ex
2)physiological thoracic and lumbar mobilisations in rotation direction
very gently from prone
3)reeducation of side rolling from prone
4) advices
third day
breathing better
pain with neck flexion decreased
i contuined as the first day , more ,
sitting balance training
neural mobilisation in the form of knee exte&neck exte and vice (3 times)
5 day
dorsi flexors begin to work from grade 0 :arrow: 3+
i contuined , more gently
physiological mobilisation of trunk from sitting
sitting to standing training , however knees were taking flexed degrees
7day
the clonus reaction begin to decrease , this is NOt what i assessed first
day
i contuined the program as above , with more progress in neural
mobilisations progression .
third week
now , he can walk on the wall , blinth , with one person handling from
hand , the clonus disapperaed in one lower limb.
Conclusion
i do not know , is neural mobilisation the back ground of the motor progression occured :?: :?:
current problem
bowel and bladder control are lost completelt ,with catheterisation , i can not help , could neural mobilsation help , any training :idea: :?: :?:
cheers
emad
I have one case study now , really iam hesitated to put it also under the same topic , then for example as case stude 2 ,..... 3 ...4
========================
The case : Bladder & Bowel control could be improved through neural mobilisation.
An adult 17 years male , i have asked to assess in the public hospital ,He was hospitalesd in the university hospital for about 35 days , then returned back .
Past history
All papers i have read about the month before i assessed him , denote that patient was admitted to the hospital with fever , and now it is paraparesis.
Present history (objective)
I found
1) a case of paraparesis ,bed ridden patient , with no bed sores.
2) Hyperreflexia
3) + clonus of both lower limbs
4)sitting was unbalanced
5)i had not tried to test standing so
6)cough and breathing was difficulty
7)lumbar region was highly in temperature ,when i touched
8)from sitting , i asked the adult to flex neck :arrow: back pain
hypothesis#
I considered the case meningitis , inflammation of the spinal cord , result in upper motor neuron lesion .
First day treatment
1)breathing ex
2)physiological thoracic and lumbar mobilisations in rotation direction
very gently from prone
3)reeducation of side rolling from prone
4) advices
third day
breathing better
pain with neck flexion decreased
i contuined as the first day , more ,
sitting balance training
neural mobilisation in the form of knee exte&neck exte and vice (3 times)
5 day
dorsi flexors begin to work from grade 0 :arrow: 3+
i contuined , more gently
physiological mobilisation of trunk from sitting
sitting to standing training , however knees were taking flexed degrees
7day
the clonus reaction begin to decrease , this is NOt what i assessed first
day
i contuined the program as above , with more progress in neural
mobilisations progression .
third week
now , he can walk on the wall , blinth , with one person handling from
hand , the clonus disapperaed in one lower limb.
Conclusion
i do not know , is neural mobilisation the back ground of the motor progression occured :?: :?:
current problem
bowel and bladder control are lost completelt ,with catheterisation , i can not help , could neural mobilsation help , any training :idea: :?: :?:
cheers
emad