Week One

S: This week I was given a 90 yr old male patient with a history of CRF and two AV replacements that needed rehabilitation after deconditioning as he had been hospitalised for the last 2 months. He was able to walk approximately 10m with a wheeled zimmer frame with one standby assist before fatigue.

T: My task was to perform an initial assessment of his mobility, muscle strength, muscle ROM, and balance in order to begin a treatment plan.

A: I performed the relevant assessments required using outcome measures to qualify my assessments. I used the Oxford scale for muscle strength, measure relevant muscle ranges with a goniometer and performed the Berg Balance Scale as an assessment for balance. To also assessed his static and dynamic sitting and standing balance and ambulation.

R: After carrying out these assessments, the patient received at least 3/5 for each relevant muscle regarding muscle strength, and a Berg Balance Scale of 40/56 indicative of a falls risk. He was safe in his static and dynamic sitting and standing balance

E: The main issue I had carrying out the initial assessment was during my Berg Balance testing. I found it difficult to ensure I was able to perform the assessment safely, and in particular, the latter parts of the assessment such as picking an object off the floor and reaching forward.

S: I asked my supervisor for assistance during those later parts of the Berg Balance assessment to ensure the safety of the patient and myself. I also was able to find out the best positions to place my body to ensure the assessment was safe and practice these throughout the week to build my confidence in performing the assessment and make sure I was being safe.