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Physical Disability & Walking Rehabilitation (a case study)

The person we have been working with has had his name changed to protect his identity, but for the readability of this case study, we will refer to him as Mike.

Mikes Condition

Mike was living with a learning difficulty alongside a physical disability, we have been working with Mike for over 6 months now, and after a long period where his walking and overall fitness have declined, we were brought in to help with encouraging Mike to get back his independence and mobility. He was in a wheelchair however he was encouraged to stand on his own for short periods during personal care, our goal was to increase this and with the long-term goal, if possible to give him the ability to walk on his own unaided.

Initial Assessment

After a couple of sessions and assessments with Mike, I noticed 4 issues which were to be my main short to medium-term goals to focus on.

  1. Left hamstring tightness

  2. Right ankle weakness

  3. Overall balance

  4. Confidence

Once these were discovered my main focus was very massage and range of motion based, increasing his hamstring length (lack of tightness) and strengthening his ankle as he would roll onto the inside of his foot when weight was added to it.

During this time I encouraged fun and engagement to help Mike enjoy the sessions.

Standing / Balance work

After the first 2/3 weeks, standing was encouraged and supported walks (about 3 feet) to his bed were done multiple times per session, in-between I would allow him to rest and work on flexibility and strength work. I would also throw in some unrelated exercise-based games to keep him engaged as sometimes he would find this taxing.

After around 6 weeks I started to see that he could hold his own weight for short periods which I would safely encourage.

More Advanced walking

We then started to encourage Mike to walk for longer periods, with only one hand support and with the help of the staff he started to use the handrails in the halls where he would walk about 10m unassisted (with small gaps in the rail which we assisted him). Alongside this, I have now added lateral work (side to side) as well as more advanced stretches that include glute (bum) stretches and knee flexion and extension. Last few weeks we have allowed Mike to walk unassisted for a limited amount of steps, this is done with myself and at least 1 other member of staff so we can do this safely however I believe that allowing him to feel supported but also encouraged to do it on his own is paramount, huge things are to come of Mike as we are only part way through his journey.

Take Away

Getting the staff involved was a huge part of Mikes's progress, and credit where credit is due the staff at this home were fantastic and a huge credit to his wellbeing and rehabilitation. Keeping the rehab progressive, and adding additional stimulus when possible is also huge, finding that right balance is sometimes hard when communication with you and the resident is difficult, which is why I feel staff engagement in this area is also very important. If you have enjoyed this read and would like to learn some more about service users we have worked with please leave a comment about the area you would like to us to cover.


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