Trish was independently living with her husband in their home in Hampshire. She worked within a pottery painting setting and supported her husband with their family holiday park which they run in Devon. They have one daughter and a good social network of friends and family.
Trish was driving and would carry out a busy day to day life carrying out shopping, cooking, walking their dog and spending time with her daughter.
• Left facial drop with lack of sensation
• Left upper limb weakness with impaired sensation and proprioception
• Subluxation of left shoulder with associated pain
• Left leg weakness resulting in needing a quaradpod and assistance of one to walk
• Increased levels of anxiety
• Reduced concentration and attention
• Increased tone in left lower and upper limb
• Mobilising short distances with the assistance of one and an aid
• Dependent on husband to complete all activities of daily living
• Assistance of one and equipment to complete all transfers at home
• Able to complete short simple activities in sitting with verbal support
• Need of toileting equipment and the assistance of one to carrying out all toileting needs during the day and night
• Unable to drive
• Unable to use left hand to write, use phone or laptop
• Able to communicate well in conversation with good awareness of physical and sensory impairments
• Poor ability to recall all information due to mild cognitive impairment and high anxiety
Specialist Neuro Occupational Therapy input:
• Trish was seen in the outpatient clinic and within her home environment over a 7 month period of intensive therapy.
• Trish worked on functional based goals around her personal care, transfers and mobility and increasing the use of her left upper limb.
• Trish carried out practice within her kitchen, bedroom and bathroom encouraging her to proactively engage more in activities and reduced the carer input from her husband when at home and in the community.
• She completed a sensory UL programme, hand writing practice and regular fine motor and gross motor activities.
• Neuro Upper limb and functional technology was used within sessions alongside hands on therapy to work on improving her sensation and strength in her left upper limb with therapy programmes being given to continue practice when at home.
• Trish was seen daily over a number of weeks. She thrived on encouragement and reassurance and consistency by all therapists involved at home and in the outpatient clinic.
Specialist Neuro Physiotherapy input:
• Trish was seen at home, in her local community and within the Winchester clinc. Her goals focused on improving her walking pattern, gait quality, her endurance, and ability to walk without using an aid or foot support.
• Trish was very motivated and engaged, despite being anxious at times she continued to put her rehab programme into her daily routine at home and practice in and outside of therapy sessions.
• Trish came to Hobbs walking with a orthotic splint and heavily dependent on a stick or her husband’s arm for support.
• At the end of her treatment Trish was independently walking without an aid or splint. She is able to walk around her home including the stairs independently and had begun walking at the beach with a stick towards the later end of her intensive rehab programme.
• Mobilising independently without an aid indoors and with 1x stick and distant supervision when outdoors
• Independent using her shower and washing/drying her hair with environmental set up
• Able to get in and out of her bath independently
• Independent with all toileting needs without the use of equipment
• Independent completing the stairs at home
• Able to wash up, load and unload the dishwasher and make herself and her husband a cup of coffee
• Able to assist with meal prep and hold and push a trolley when completing the weekly food shop
• Able to write her name and address using a pen grip with her left hand
• Increased strength in left upper limb which enabled her to carry items using both arms and light objects in her left hand
• Practicing driving in driving simulator with the most recent outcome being that the DVLA have said Trish is safe to drive and she is getting a new mini to drive
