Case Study 과 목 명 : 임상생체역학실습 담 당 교 수 : 황 성 수 교수님 발 표 일 : 발 표 자 : 김 건 욱
Name : 이 ㅇㅇ Age : 55 Sex : F DX.: Lt. hemiplegia d/t Rt. Thalamic hemorrhage On set : Information
C.C : Lt. shoulder abduction 시 약 80 ° 범위부터 deltoid 에 발생하는 pain 이 가장 불편 Patient`s goal : 일상생활 도중 Lt. side U/E 를 사용할 때 통증과 Rt. Side 를 사용할 때 발생하는 hypertone 이 없어졌으면 좋겠다 Information
Consciousness : alert Attention : good Orientation (T, P, P) : +/+/+ Language : vocal Mental Status
Range of Motion (Lt. side U/E) ActivePassive Shoulder flexion160°170° extension30°40° abduction130°170° adduction40°45° Int. rotation45°60° Ext. rotation60°80° Elbow flexion120°130° extension150°180° Wrist flexion70°80° extension60°70°
1. Sitting to standing48. Reaching forward with outstretched arm 3 2. Standing unsupported49. Retrieving object from floor4 3. Sitting unsupported410. Turning to look behind4 4. Standing to sitting411. Turning 360 degrees4 5. transfers412. Placing alternate foot on stool4 6. Standing with eyes closed413. Standing with one foot in front3 7. Standing with feet together414. Standing on one foot3 Total = 53/56 Berg-Balance Test
Assessment Lt. scapular upward rotation - Lt. trapezius hypertone - Lt. Rhomboid weakness
Assessment Lt. side U/E AR - Biceps brachii hypertone - Pectoralis major hypertone
Goals Short term goal - Lt. rhomboid strengthening & trapezius release - Biceps brachii release Long term goal - 상부 체간의 안정화를 통한 shoulder pain 감소 및 상지의 hypertone 감소
Scapular stability A : PT`s with therapist B : pelvic setting 후 rhomboid 의 activation C : sitting D : 10min.
Scapular exercise A : PT`s with therapist B : scapular protraction & retraction C : sitting D : 5min.
Humerus head slide A : PT`s with therapist B : humerus head 의 inferior slide C : sitting D : 5min.
Biceps brachii Contrax-relax A : PT`s with therapist B : biceps brachii 의 능동수축 후 이완운동 C : sitting D : 10min.
Plan 30 min. / time 2 time / day 5 day / week Reassessment 4 weeks later
Home exercise