Andrew is a 34-year-old gentleman who acquired a neurological brain injury following a road traffic collision in 2012. Prior to the injury, he was fit, sporty, and training to be an engineer. He had a passion for hockey and represented his age group for the Hampshire teams.
He first attended Hobbs Rehabilitation from 2014–2018 and returned in 2022, attending weekly sessions ever since.
Andrew’s initial goals focused on functional gains in his home environment, and he has excelled at this, integrating his right arm into personal care and exploring domestic tasks such as baking and cooking.
A major focus for Andrew has always been improving his ability to play golf and the quality of his archery, which he enjoys with his father. He now reports regularly achieving a bulls-eye!
He has worked with both Hobbs Rehabilitation and his personal trainer to improve his endurance and has competed in the Superhero Triathlon over the past three years, including last year as part of their celebrity team. His current goals include completing a group walk in the local area, with a longer-term aim of completing a ParkRun.
Andrew’s rehabilitation has been supported through neurotechnology integration, specifically:
• Balance training using the Strolll, and
• Strength and range of movement exercises using the ROBERT, which have been pivotal in helping him progress toward his functional and sporting goals.
•Reduced confidence
•Altered gait pattern – walking, not able to run at present
•Reduced coordination and dexterity
•Mild right arm weakness
•Mild right leg weakness – especially in posterior chain and •reduced explosively/absorption of calf muscles particularly
•Right upper and lower limb increased tone and spasticity
•Reduced proprioception through right side and central body areas
•Reduced dynamic and reactive balance
•Reduced visual and vestibular impairments.
•Reduced coordination and weakness in right hand
Right sided visual neglect
•Cog-comm difficulties
•Fatigue and reduced endurance
On previous admission
•Walking short distances with 4 wheeled walker inside and outside
•Minimal functional integration of the right upper limb, and subsequent assistance required with all personal activities off daily living.
•Reduced confidence and ability on stairs
•Reduced participation in everyday activities
•Andrew is consistently motivated and engages really well in weekly therapy sessions. In order to increase the intensity to improve his outcomes, we work closely with his personal trainer, and dedicated care team.
He has been prescribed with:
•Ankle stretches
•Balance exercises, gradually exploring more dynamic exercises and progressing this as indicated.
•Arm stretches, and supported to have a wrist splint to use for prolonged stretch.
During sessions we work on
•Strength programme working in different postural sets to improve strength and length around shoulders.
•Balance- static and dynamic
•Referral to spasticity services, and injections of botulinum toxin into right ankle, right pectoral, biceps and wrist flexors (at different times) and subsequent follow up to improve range and strength around them.
•Walking practice on the treadmill and assessments for use of functional electrical stimulation, including the NeuroTrac, PACE and Bioness.
•Neurotechnology integration for balance (using the Strolll), and strength or range through use of the ROBERT.
•Task and sport specific exercises – focussed on golf swing, rotation and archery draw
•Liaison with PT and clinical massage therapist
•Able to write legibly with the right hand- able to write his own Christmas cards
•Able to use a camera with two hands
•Able to wash and dress himself with a chair for support.
•Able to cook and bake with minimal assistance for set up and safety from his care team.
•Able to walk inside and outside with a walking stick
•Improving quality, performance and enjoyment of archery and golf with his father
•Improving his endurance by exploring challenges such as the Superhero triathlon- cycling the 20km route with his personal trainer in a tandem bike
•Held his friend’s baby and was able to feed her with a bottle.
•Can put on own shoes with both hands, and able to put on his hat with both hands
•Able to shake people’s hand and use the right hand for communication gestures. Continuing to work on his high five!
•Able to walk on the treadmill for 10 mins at different speeds.
•Managed to walk on a boat when he went on a cruise with his carers, and walked on the Norwegian ice with assistance from a carer and a walking pole!
Andy enjoys both the standard therapy and sessions with ROBERT but the ROBERT in particular, he finds a lot of fun and a good challenge. He also appreciates the interactive screen, which he finds engaging. He shared that ROBERT has been a huge help with his archery. He feels that his arm is much stronger when pulling back to aim his arrow, and lifting his arm has become noticeably easier.
