MS case - Millie PART 1

Question 1

What is the prognosis?

Answer 1

poor
- extreme fatigue
- unable to mobilise independently
- LLL decreased ROM
- reduced coordination
thus, unlikely to complete ADLs
- IVMP take down > to weak to manage thus symptoms cannot ease

Question 2

Factors support diagnosis?

Answer 2

• female
• younger adult
• single episodes of neuro inflammation > tripping and diplopia combine with female gender and age suggest relapsing remitting

Question 3

Short term goals

Answer 3

• hold herself upright independently and maintain posture for 20 second in 2 weeks
• sit on a plinth independently in 2 weeks
• stand from plinth with hoist and AO1 2x standing for 1 min in 3 weeks

Question 4

Long term goals

Answer 4

• complete ADL without extreme fatigue after single task
• play violin for 10 mins

Question 5

Prioritised problem list

Answer 5

• hoisted for all transfers > no freedom movement
• extreme fatigue on singular movements
• unable to maintain sitting posture
• LLL reduced power and ROM 2/5
• RLL and UL slight reduced power > likely due to fatigue

Question 6

Red flags?

Answer 6

• loss of coordination > chance of central lesion
• disease is progressing