Multiple Sclerosis - A Practical Guide to Rehabilitation - 48

AIMS

A PRACTICAL GUIDE TO IDIOPATHIC PULMONARY FIBROSIS

Putting it All Together-Case Scenario 1
CHARLOTTE
Charlotte is 67 years old. She was
diagnosed with MS 35 years ago.
She lives at home with her husband,
who is 70 years old and is generally
in good health, but somewhat frail.

Charlotte's current MS challenges include late-onset cerebellar issues presenting as ataxia, problems with fine
motor coordination, and fatigue. She reports some difficulty with dressing and transfers (toilet and shower).
Her husband has been trying to help but is finding it increasingly difficult. She reports having one significant
fall in the recent past, along with several other "close calls."
Charlotte is a former smoker (24 pack year); she quit 10 years ago. Last year, she was diagnosed with chronic
obstructive pulmonary disease (COPD), which currently is considered mild (GOLD Stage 1). Charlotte also has
osteoarthritis primarily affecting her hips and right hand.

ASSESSMENTS

- Dynamometry (hand grip strength):
11 lbs (right hand); 18 lbs (left hand)

* Physical Therapy

- Canadian Occupational Performance
Measure for goal identification

- 2-minute Walk Test, with no assistive
device: 320 feet; norm for age is 508 feet
- 25-Foot Walk, with no assistive device: 9.3
seconds; norm is < 6.1 seconds
- Berg Balance Scale: 25/56; consistent with
high fall risk

* Speech-Language Pathology: Charlotte was
referred to SLP for speech and swallowing (no
issues noted) and for breathing support.

- Five Times Sit to Stand: 19 seconds;
consistent with high fall risk

* Other assessments:
- PHQ-9 score: 7 (suggests mild depression,
need for watchful waiting)

* Occupational Therapy
- 9-hole Peg Test: 48 seconds (right hand);
27 seconds (left hand)
- Box and Block Test: 20 blocks (right hand);
28 blocks (left hand)

48

- Home evaluation identifies a need for grab
bars and an anti-slip mat in the combined
tub/shower, removal of throw rugs and
mats in hallways

Case 1: Charlotte



Multiple Sclerosis - A Practical Guide to Rehabilitation

Table of Contents for the Digital Edition of Multiple Sclerosis - A Practical Guide to Rehabilitation

Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 1
Multiple Sclerosis - A Practical Guide to Rehabilitation - 2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 3
Multiple Sclerosis - A Practical Guide to Rehabilitation - 4
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Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover3
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover4
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