Day 5 of Prac 17/10/08

Today i was asked to assess patient a's balance using the Berg balance scale and work through the patients exercise program. I felt comfortable and confident using the Berg Balance scale and so was quite comfortable to use this outcome measure. Patient A was admitted to Carinya with a stroke. He was fairly good and independent ambulation however he sometime struggles with foot clearance of his right foot (especially when walking outdoors), endurance (he can walk about 10mins outside) and he struggles with function of his right arm and hand which rests suported in a sling when not exercising.

I explained to patient A what i planned to do with him that day but it made easy by the fact he had had a berg balance test performed whilst he was in hospital and he has a fairly sound communication and understanding (only sometimes finding that he can't say/explain what he is thinking or what he wants to say). Patient A's Berg Balance results had improved from 46/56 to 51/56, which was good to see. Patient A should be ready for discharge soon.

I then proceeded to do his exercise program with him. He has done the program for a while so he knows what the exercise is and how to do it once prompted. The exercise program consisted of LL strengthening exercises as well and upper limb exercises where i tried to encourage movement of his right upper limb, especially his wrist and fingers where he had little AROM.
I then did some complex standing balance exercises in the parallels as well working on patient A's stepping and weight shift to assist with his gait.

I was happy with my work with patient A, however i think he is beginning to find some of the exercises orginally prescribed as too easy (however others are still complicated), so i would like to review his program and maybe give his some new exercises as well as incorporating some functional tasks to challenge him a bit more.