Monday, 3 September 2007

Functional retraining: yes or no

H is a 54 yo male presented to my neuro clinic with 6 month history of
R hemi. He used work as a handyman in a hospital and expecting to go back to work after he recovers.I have been focusing on treating his upper limb function.
Treatment consists of mobs, exercises (to facilitate selective movement
of upper limb and hand) and functional skill retraining. He does the exercises well (reaching, hand stereognosis, wt bearing). however, when he comes to functional skills (eg picking up an object from a table, folding up a tower) he becomes frustrated/distressed and he appears to rush as well. As a result, his tone and ataxia really gets worse after the functional retraining. Does that mean that my functional tasks is not appropriate for his stage of recovery? There is Psychological issue here? I would like to retrain his functional skills in each session to maximize the outcome of my treatment, however, the real outcome is that the functional retraining really undoing my previous work.I discussed the issue with my supervisor and he thought my facilitating technique is OK and it could be due to his emotional issue. Anyways, shall I stop the functioal retraining or shall I carry on? Is there any suggestion here?

1 comment:

Unknown said...

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Work Injury Physio