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Case Study

SR | Brain Tumour | South East

Presented with deterioration in walking and balance for around 2-3 weeks prior to seeking medical review, and was walking with 2 Fischer sticks. Diagnosed with atypical Meningioma, which was compressing his brainstem. Treated with surgery 17/09/23 to remove 95% at Wessex Neuro Centre, and left with bulbar symptoms. He was discharged home on 29/09/23. Following this he had difficulties with blood pressure regulation, swallow and mobility. Due to difficulties with swallow, he lost a significant amount of weight.

Main Areas Affected

• General deconditioning, most prevalent in left lower limb
• Mild decreased left lower limb co-ordination
• Decreased static and dynamic balance
• Decreased vestibular and sensory integration
• Diplopia
• Dysarthria- PEG fed and unable to manage his saliva without use of a portable suction machine
• Postural hypotension

Functional Ability on Admission

• Using a portable suction machine to manage his saliva
• Mobilising using a 4 wheeled walker inside
• Managing stairs with assistance of one
• Wash and dress with assistance of one in sitting
• Assistance for meal preparation and household chores
• Altered role within family, and unable to work
• Unable to drive

Hobbs Rehabilitation Input

• Physiotherapy and Speech and Language Therapy outpatient assessment session
• 6 Physiotherapy outpatient sessions
• 5 Speech and Language Therapy outpatient sessions

Functional Ability on Discharge

• Walking independently unaided inside
• Walking unaided outside on the level, using a walking stick for hills and on uneven surfaces such as the beach
• Walking up the stairs to watch football
• Eating a normal diet and drinking normal fluids
• Managing his own saliva without a suction machine
• Return to wash and dressing independently
• Beginning gradual return to work

Outcomes

Timed Up and Go
49% Improvement
miniBEST
39% Improvement
Modified Clinical Test of Sensory Interaction in Balance
19% Improvement

Goals

To return to full oral intake of normal diet and fluids, and remove the PEG
Achieved
To be able to walk outside confidently without a walking aid.
Achieved (1 Hour)
To be able to go to a Saints football game (with a walking stick as crowds can be challenging to negotiate)
Achieved

Testimonial

After my brain tumour operation in September 2023, I faced swallowing, speech, balance, strength, and walking challenges. Sophie focused on my swallowing initially, providing daily exercises and online therapy. Now, my swallowing and speech have improved significantly, and I’m having my feeding tube removed! With Emma and Emily’s physiotherapy sessions, I’ve strengthened muscles for walking and balance. Their ongoing guidance and encouragement helped me progress from a walker to using one walking stick outside. I’m now walking unaided at home and aim to do so outside. Thanks to Hobbs’ incredible support during my difficult journey.

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