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PAL Presentation

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by

Vanisha Parmar

on 25 February 2014

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Transcript of PAL Presentation

PAL Presentation
By: Vanisha Parmar
Introduction
Gain the perspective on how patients with neurological conditions are prescribed treatment.
To observe several treatment techniques.
Learn more about the patient-physiotherapist relationship.
Clinical Area: Neuro Outpatient Rehab
Patients
Stroke
Multiple Sclerosis
Parkinson's Disease
My Expectations
Patient's Condition
Multiple Sclerosis
MS is a neurological condition of the brain and spinal cord
Auto-immune disease causing demyelination of nerves
The Patient
Physiotherapy Management
Patient with Multiple Sclerosis

Female, Age 43
Diagnosed in 2000
Relapse-remitting MS. (last relapse in 2013)
Gait is affected, increased adduction.
Elbow crutch needed (left side)
Dropped arches & over pronation causing left knee pain.
Increased tone and spasticity throughout lower limbs.
Decreased sensation in right gluteal area.
Independent in doing her ADL's.
Software developer, works from home.
Living with her adopted 4 year old niece.
Enjoys doing yoga.
Implications
Difficulty walking and doing ADL's.
Increased fatigue.
Loss of sensation interfering with exercises.
Care of and engagement with niece is affected.
Short term goal: Improve gait pattern and speed
Long term goal: Management of gait pattern and spasticity in LLs

Physiotherapy Inventions
Stretches for the quadriceps, adductors, and calves
Strengthening of hip abductors
Gait re-education
Repetitive movements to increase neurological plasticity
Use of ankle foot orthosis (AFO)
Influencing Factors
Limitations
Fatigue due to MS and Baclofen (anti-spasicity drug)
Increased tone causing difficulty walking
Biopsychosocial Aspects
Limited interaction with niece Employment opportunities
Self-efficacy
Public opinions
Conclusion
Reflection

What Spasticity Feels Like

Multiple Sclerosis

Patient's Appointment Length

What I found Interesting
What I Learnt
Physiotherapy Interventions for MS

Patient-Physio Relationship

My Interest In Nuero Rehab :)


Impact of Physiotherapy
Neuroplasicity
Holistic Approach
MDT (ex. counselling)

Increases self confidence

Improves quality of life


10m Walk Test
31 steps in 31 seconds
25 steps in 21 seconds
References
Kimberley, T. J., Samargia, S. & Moore, L. G., 2010. Comparison of amounts and types of practice during rehabilitation. Journal of Rehabilitation Research & Development, Volume 47, pp. 851-862.
Mandal, A., 2014. News Medical. [Online] Available at: http://www.news-medical.net/health/Multiple-sclerosis-(MS).aspx [Accessed February 2014].
Medical Supplies & Equipment Co. , 2003. Use Of Parallel Bars In Rehabilitative & Physical Therapies. [Online] Available at: http://rehabilitation-products.medical-supplies-equipment-company.com/PPF/page_ID/195/article.asp [Accessed February 2014].
National MS Society (2014). Living with MS. [Online] Available at: www.nationalmssociety.org [Accessed February 2014]
NICE Guidelines, 2004. Multiple Sclerosis. The National Collaborating Centre.
Podiatry Today, 2013. Exploring The Potential Of AFO Devices. [Online] Available at: http://www.podiatrytoday.com/article/1167 [Accessed February 2014].
Stokes, M. & Stack, E. (2011) Physical Management for Neurological Conditions, 3rd Edition. Churchill Livingston: Elsevier
Transcendental Meditation, 2013. TMHome. [Online] Available at: http://tmhome.com/transcendental-meditation-benefits-research-effects/tm-helps-patients-with-multiple-sclerosis/ [Accessed February 2014].
(WebMD,2014)
(Mandal,2014)
(Transcendental Meditation, 2013)
Maximizing reps to rebuild necessary cortical pathways through neuroplasticity and achieve greater functional improvement.
(Kimberley, et al., 2010)
(NICE, 2004)

Patients Condition
Social History
Progressive
Relapsing- Remitting
(Bregman, et al., 2011)
(Podiatry Today, 2013)
(Podiatry Today, 2013)
(Podiatry Today, 2013)
(Medical Supplies & Equipment Co. , 2003)
Thank You!
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