MS case - Millie PART 2

Question 1

What is the prognosis?

Answer 1

moderate improvement
- use dominant hand
- sit independently
- can mobilise more > not independently
- LLL muscle strength improved
- coordination still reduced but has improved
- less fatigued > completed sensation test

Question 2

Short Term goals

Answer 2

• STS from plinth independently over observation of therapist in 2 weeks
• transfer on ward without apparatus and only therapist assistance
• 2 lengths of the parallel bars with AO1 in 3 weeks

Question 3

Long term goals

Answer 3

• diminish anxiety and fear of falling
• reduce fear of coping with ADLs at home
• use of steps independently

Question 4

Red Flags

Answer 4

No immediate concerns with red flags

Question 5

Other points to address

Answer 5

• fatigued at 3 mins rather than 30 seconds > 6x longer
• spasm and stiffness in LUL > high tone

Question 6

Prioritised problem list

Answer 6

• transfers have to be carried out on molift
• LLL dorsiflexion 1/5 > difficulty stepping and clearing from floor
• fear of falling
• LLL weakness
• LUL spasm, stiffness and discomfort
• coordination remains reduced