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Hello, can please answer the questions at the bottom based on this Bariatric case study for my Rehabilitation of Specialized disorders class, I am in a PTA program. Thank you so much! History: Patient is 51 year female. She weighs 308 pounds (140kg) and is 65 inches height (165 cm). Baseline HR 82 beats/minute and BP 140/90 mm/Hg. PMH/Comorbidities: HTN, OA to B knees, low back pain and type II DM (controlled w. medications) Social History: Patient lives with her husband in a single story home with one step to enter. Husband is able to provide some assistance. Patient has been on disability for 2 months but would like to return to work as an executive assistant. Patient was previously independent with mobility and daily activities but has required increasing assistance over the last 6-8 weeks. Patient’s Goal: “To be able to walk 1 block and go back to work” and improve independence with bed mobility and transfers. Joint ROM Measurement (bilateral) · Hip Flexion = 0-65 degrees, SLR = 0-40 degrees · Knee Flexion = 0- 50 degrees · Ankle Dorsiflexion = 0-10 degrees · Glenohumeral Flexion = 90 degrees · Glenohumeral Abduction = 90 degrees Muscle Strength (bilateral) · LEs: Hips = 3-/5, Knees = 3-/5, Ankles = 3-/5 · UEs: GH Flexion = 3-/5,GH abduction = 3-/5, Elbow = 4/5,Wrists/Hands = 4/5 · Trunk Extension = 3-/5, Trunk Flexors = 2+/5 Mobility · Bed mobility: supine ↔ sit with Min A · Transfers: sit ↔ stand and step to transfer with Min A · Ambulation: limited to a few steps with Mod A without an AD; significant gait deviations including decreased stride length, wide BOS, decreased cadence, and short stance time bilaterally. Patient amb. 15′ with bariatric walker and Min A. Pt. c/o SOB with gait. O2 sat = 91% and respiratory rate = 20. Impairments · Decreased strength throughout · Decreased functional ROM · Decreased independence with mobility · Decreased independence with gait, limited endurance and gait mechanic deficits STG (1 – 2 days) 1. Patient to perform bed mobility with CGA. 2. Patient to perform sit to stand with CGA 3. Patient to transfer bed to chair with CGA and least restrictive AD. 4. Patient to ambulate at least 40 feet with CGA and least restrictive AD with Respiratory rate under 20 and min c/o SOB LTG (1 – 2 weeks) 1. Patient to be independent with bed mobility 2. Patient to perform transfers with mod I and least restrictive AD. 3. Patient able to ambulate at least 100 feet with mod I and least restrictive AD with minimal SOB. 4. Up/down 1 curb step with min A least restrictive AD 5. Patient to be independent with a progressive HEP aimed to increase strength, ROM, and endurance. Physical Therapy Treatment Plan · Therapeutic exercise to improve strength and ROM · Bed mobility training · Transfer training · Gait training for limited community distances · Stair training · HEP instructions and other patient education 1. Using the ICF model list the medical diagnosis, the physical therapy diagnosis, impairments, functional limitations, and disabilities for this case. 2. What risk factors does this patient have that contributes to obesity? What are the indications for PT treatment? Are there any potential contraindications? 3. Identify any interventions in the POC that are outside of the scope of the PTA? 4. Identify and list any abnormal findings from the evaluation. What is the significance of the findings? (if applicable) 5. Identify additional information that you may need from your supervising PT to plan your treatment program? (must identify at least 2 items for full points) 6. Identify and collect any additional data that you need to monitor/treat this patient safely? 7. Design and perform a treatment session lasting 30 – 45 min for this patient for 3 phases of rehab: Acute Phase, Chronic Phase, Lifelong (HEP) utilizing web based resources 8. What education should be provided to this patient? Appropriate education is provided to the patient. 9. If both OT and PT were involved with this patient, what would you see as the role for each discipline to provide an appropriate, comprehensive treatment program? Consider concepts of co-treatment and expert consultation in your answer. 10. What compensatory strategies might you teach the patient in this case? 11. What types of DME might be recommended for this patient? Why would you recommend this DME? 12. Which portion of the POC would you delegate to an aide/tech? Provide your rationale for your answer. What community supports could you use for this home care patient to address her need for psychosocial support?
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