Geriatric Case Studies

Case Study #1

70-year-old male diagnosed with Parkinson's about 3 years prior. Patient presented with resting tremors in hands and neck, forward head posture and rounded shoulders, shuffling gait with reduced arm swing and overall reduction in strength and endurance. Patient does take Sinemet and Levodopa.

Interventions for this patient included LSVT Big and Loud therapy, "big" walking, balance/coordination activities, stretching, and cardio on the Nustep. Since I am not trained in LSVT I was only able to mirror the exercises and give verbal and tactile cues. I was able to do balance and neuro re-ed with both static and dynamic balance exercises. (I did have an opportunity to participate in a group Big & Loud session). Some of the assessments we used to track patient progress included the 6 minute walk test, TUG test and the four square step test. I was only able to work with the patient for 3 weeks but we did see improvements in his speed, balance and ROM.

Case Study #2

76-year-old female with lumbar scoliosis and post right total hip replacement 6 months prior. Patient presented with Trendelenburg gait on affected side and bilateral valgus at knees. She was not engaging her glut med, but compensating with her hip flexors, glut max and QL.

Patient was unable to perform hip hiking on a step, had difficulty performing hip-hiking while partially unweighted at an incline in the Total Gym and could not perform side-lying hip abduction without assistance. She was unable to isolate her glut med in standing hip abduction. We were finally able to help her isolate her glut med with supine hip abduction with her heel on a slider. We did cardio on the Nustep, balance and neuro re-ed activities, lateral stepping over cones, clams, weighted A/P and lateral walkouts and core strengthening. We also taught the patient positional traction in side-lying to help with the scoliosis. The patient was very diligent with walking and doing her HEP. In my 5th of 5 weeks at the clinic she proudly demonstrated 10 reps of side-lying hip abductions and was also able to perform hip hiking on a step. Her lateral lean was greatly decreased and her hip drop was less noticeable.

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