Case Study Questions Flashcards
Your patient is a 20 y/o student who sustained a concussion injury 13 months ago while playing football. He has since been discharged home 2 months ago after a stint at the Brain Injury Rehab Unit.
He wants to work on his football throwing skills. He has not thrown a football since his injury and this now feels very new to him. Describe how you will go about progressively training him to throw a football – taking into consideration your knowledge of “task attributes” (4 marks)
Start with a lighter ball throwing it statically in one spot
Throwing an actual football on one spot, throwing and then catching in one spot
Throwing a lighter ball while walking, then throwing and catching while walking
Throwing a football while walking, then throwing and catching while walking
Throwing a lighter ball while running, then throwing and catching while running
Throwing a football while running, then throwing and catching while running
The student should be able to give any 4 of the above
You are a physiotherapist providing outpatient rehabilitation for a 47 year old mail room attendant who had a traumatic brain injury (TBI) 3 months ago. He has not returned to work but is keen to return to the same role. Generally his muscle strength is around 3/5 in all the major anti-gravity groups, and his coordination skills are improving though he is slow. This coming week you are focusing on the task of reach and grasp in preparation for return to work. Currently he can stand and reach to grasp a letter but he cannot consistently grasp a letter between fingers to place in letter box/pigeon hole.
Outline a therapy session for rehabilitating this upper limb tasks for each of the practice types given in parts a,b,c. Justify for each part (a,b,c) which would likely be most effective with a brief justification for your choice.
Whole versus part practice (3 marks)
Guided versus discovery practice (3 marks)
Constant versus variable practice ( 3 marks)
Whole - do whole task of picking up letter and placing in mail box/pigeon hole (1)
Part – eg practice hand shaping for letter; practice grasp and release; practice transport; lift and lower, etc etc (other reasonable part tasks ok) ie parts (1)
Whole = better transference of task (1)
Guided: cue through task, eg reach for letter with R hand, open fingers wide enough (1)
Discovery – set up desk with letters and mail boxes…Where do the letters go? Ie get them to do whole task without giving cues, best to ask them to perform a task in context (1)
Discovery more effective long term.(1)
Constant is doing the same thing over and over again – same shape and weight of letter into same letter box at same height etc etc. (1)
Variable is using different sized letters/packages, posting at different heights etc etc.(1)
Variable = more effective learning. (1)
Which of the following is not a test of upper limb coordination?
a) Finger to nose
b) Rapid-alternating pronation supination
c) Modified Ashworth test of elbow flexors
d) Pointing and past pointing
C
Which of the following statements is an example of knowledge of results for a throwing task?
a) You stepped forward with the correct leg during throwing
b) The ball hit the target
c) That was a good wind up phase of throwing
d) You need to rotate your body more
B
You have been referred an 80 year old woman who had a stroke affecting her L) side. She had a good recovery and now presents to you in the school clinic for management of her L) hand. She feels it is weak and she keeps dropping things when using her left hand. You decided to focus on working on her power grip.
What hand position is common to power grips (1 mark)?
What are the 2 types of power grip (2 marks)?
What hand position is common to power grips (1 mark)?
Object held in palm of hand
What are the 2 types of power grip (2 marks)?
Cylindrical grip
Spherical grip
