Date of Award
5-2024
Document Type
Scholarly Project
Degree Name
Doctor of Physical Therapy (DPT)
Department
Physical Therapy
First Advisor
Steven Halcrow
Keywords
Seizures, acute care, inpatient rehabilitation, physical therapy, temporal contusion, cervical fractures, clavicle fracture
Abstract
Introduction: A case report for the acute care assessment and treatment of a patient after a seizure and fall that resulted in multiple fractures and a temporal lobe contusion. Every injury has an impact on a patient’s mobility and their ability to perform activities of daily living. Physical therapists need to see each injury and understand how each one can affect the patient and have a barrier on their recovery.
Case description: A 59-year-old female who fell down 3 stairs during an absent seizure resulting in multiple fractures and a temporal contusion. The patient presented with impairments of motor planning, memory, transfers (supine-to-sit, sit-to-stand), and ambulation. Patient required minimal to maximal physical assistance and verbal cueing throughout sessions.
Intervention: The treatment consisted of therapeutic actives such as transfers, bed mobility, and ambulation. The patient was provided education on spinal precautions, precautions of clavicle fracture, and proper rolling technique. She was asked to perform actives, if patient was unable to complete the task, then cueing as well as assistance were provided.
Outcome: Patient was assessed using task specific activities and assistance level as well as Am-PAC outcome measure. The patient improved with Am-PAC score throughout their hospital stay, however there was no decrease in assistance required due to memory impairment of the patient. The patient was discharged to subacute rehabilitation for continuation of care.
Discussion: The patient made improvements with walking distance and Am-PAC score, which signifies efficacy of task specific interventions. Research on acute neuromuscular rehabilitation was not found, however task specific training we used in outpatient with improvement in function of patient. More research is needed for neuromuscular rehabilitation in acute care hospitals. Patient was not monitored post discharge from hospital to short term rehabilitation, however her prognosis was impacted due to her decreased cognitive level when leaving.
Recommended Citation
Helgeland, Kylie M., "Inpatient Physical Therapy Management of a Patient Sustaining Multiple Fractures and a Hemorrhagic Temporal Lobe Contusion Due to an Absent Seizure and Fall: A Case Report" (2024). Physical Therapy Scholarly Projects. 794.
https://commons.und.edu/pt-grad/794