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ThreeSpires Physiotherapy
24 Sanders Way
Lichfield
Staffordshire
WS14 9AD

Telephone: 07884 281623
Email Address: enquiries@threespiresphysiotherapy.co.uk

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9am - 6pm Monday - Friday.

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Physiotherapy Case Studies

Hello and welcome back again to the ThreeSpires Physiotherapy blog where we take a look at all things physiotherapy related. As a busy private physiotherapy practice seeing our patients at home in the community in areas such as Sutton Coldfield, Walsall, Tamworth, Lichfield and Cannock, our physiotherapists see a wide range of cases and I thought it would be good to share a few of these and show how important physiotherapy is to our patients and the difference it can make. Usually, I just pick one case and look at that but as physiotherapy is such a wide ranging profession and our physios see such a variety of cases I thought it would be good to look at a few case studies that illustrate the main types of patients and problems that our physiotherapy service helps with.

I have picked 5 case studies because this will cover the main types of physiotherapy that our home visit physiotherapists cover – musculoskeletal, elderly mobility and falls, neurological physiotherapy and orthopaedic physiotherapy.

Musculoskeletal Physiotherapy Case Study

Musculoskeletal physiotherapy is probably the type of physiotherapy that most people are aware of and involves helping people with their pains and problems that originate from either the muscular system or the skeletal system. A typical example would be a patient with shoulder and neck pain from spending too much time on a computer.

In our example here we have an older female (mid 70s) who has an episode of leg pain that she thinks (correctly) is sciatica. She called up and made a booking and one of our physios went out to her home in Sutton Coldfield and completed an assessment. Our patient and physio spent the first 20 minutes of her 1hr session discussing the nature of her problem, where her pain was, the severity of the pain and what was causing her pain. Our physio also looked at her past medical history and the medication that she was taking to see if that was impacting her pain. This gave our physiotherapist a good idea of the structures to look at, a hypothesis of what was most likely to be causing her pain and what the drivers of her pain were likely to be. The physio then completed a physical assessment which was used to test the hypothesis and rule in and rule out various factors. The examination revealed that the patient had pain most likely coming from her low back and the sciatic nerve and a diagnosis of sciatica was confirmed. The diagnosis of sciatica was explained to the patient and a management and treatment plan was formulated. The physiotherapist then performed some massage and manipulation on the patient’s low back and gave her a program of exercises and advice on how to get herself better. A week later at the follow up appointment the patient was very happy, her pain was almost completely gone and she was happy to manage things herself independently. Now, it is not the case that every time our physios see someone with sciatica that it disappears within one session, often it will take multiple sessions and several weeks. In this case our patient got in touch when her symptoms had first started and our physio was able to stop things progressing and enable her to calm her sciatica down very quickly.

Orthopaedic Physiotherapy

As a home visit physiotherapy service we have a large number of patients who have had an orthopaedic operation such as a hip or knee replacement and as such below I have looked at an example of one such patient.

In this case our patient was a female in her late 70s living in Tamworth who had recently had a hip replacement after a fall. She had been previously independently mobile, keeping fit by doing a lot of walking and attending Tai Chi classes but unfortunately whilst gardening she had tripped over and broken her hip. After having her hip replaced she spent a week in hospital recovering and was then discharged home to Tamworth. Her son sent us an email asking us to help her with physiotherapy and one of our physios visited her at home in Tamworth a day after she got home. On assessment our physiotherapist found that she was anxious about falling, worried that she was not going to recover her previous strength after having her hip replaced and was struggling to do her exercises and walk with the crutches that had been given to her. Fortunately, she lived in a bungalow and therefore didn’t have to worry about going up the stairs. Our physio checked through her exercises and corrected her technique with some and removed a couple that were too advanced for her at that time. Technique with the crutches was improved with practice and our physio had a long chat with her about time frames for recovery and emphasised that it takes a long time to recover from a major operation. At the end of the session the patient felt much calmer, less anxious and more positive about her recovery and the physio booked in another session for a week later. Over the next 3 months our physiotherapist initially visited the patient in Tamworth weekly but this was slowly reduced to every 2 weeks as she improved and eventually to a monthly visit until eventual discharge after 6 months when the patient felt that she was able to manage her recovery independently and was back to most of her previous activities.

Neurological Physiotherapy Case Study

Our mobile physios see a lot of patients with neurological conditions and in this case study we will look at the example of patient who has had a stroke, lives in Sutton Coldfield and has just been sent home after a couple of months in hospital recovering. Our patient is a male, 70yrs, lives with his wife, has an extended family and was previously fit and active. After booking an assessment our physiotherapist attended the family home and conducted a detailed assessment with his wife present. The assessment found that our patient had left sided weakness, was using a mo-lift to transfer with and had reduced left arm function. It was agreed that our physiotherapist would see the patient twice a week initially as both the patient and his wife understood that this was the key period for recovery and they both wanted to maximise his function. Our patient was also waiting for NHS physiotherapy to kick in and our physio explained that we would be happy to work alongside them. Over the next month our physiotherapist worked on improving the patient’s mobility and he progressed from using a mo-lift to walking with a large four pronged stick and support short distances in his home. Sessions included both mobility and upper limb rehab and the patient was given a program of home exercises that he needed to do. After about 6 weeks the patient began going to an NHS neurological rehab facility one day per week and our physiotherapist moved her sessions around this. Sessions continued over the next few months and the patient was able to progress from having someone support him walking to being able to walk with a stick independently indoors. With the patient and his family our physiotherapist identified some key goals such as moving back upstairs, being able to access the back garden (a steep set of steps needed to be navigated) and having a smaller walking aid. Our physio worked on these intensively over the next couple of months and our patient was able to go up and down stairs independently, managed to get into the garden and purchased a much smaller walking stick. Further goals such as walking outdoors approximately 15 minutes with a stick were identified and being able to walk indoors without a stick. Again sessions continued with our physiotherapist and slowly our patient was able to achieve these goals. At approximately 8 months our patient had improved a huge amount and it was agreed to reduce sessions to once per week and to look at attending a local gym and setting up an exercise program with the support of our physiotherapist. At present (approximately 12 months after his stroke) our patient has a session of physiotherapy once a week or every other week depending on availability and attends a local gym and swimming pool each week. There are still things to work on but physiotherapy has made a huge difference to his recovery.

Falls Case Study

A key part of our mobile physiotherapy service is addressing the issue of our patients having falls and in fact we have a whole article on the subject of falls. In this case study our patient is an elderly female (80yrs) living in Walsall and her family have noticed that she has been having a lot of falls recently and they have become very concerned. On assessment our physiotherapist found out in discussion with the family that things had been worsening over a significant period of time in terms of mobility and balance (at least 5 or 6 years) and that she had been having relatively regular falls over the last couple of years. Physically the assessment showed a frail, anxious lady with low exercise tolerance whose balance was very poor and who generally held onto her furniture as she walked around her property. She had no current exercise regime and also there were many trip hazards in her home that the physio identified and was able to discuss with the family and have removed. Over the next month our physio visited the patient in Walsall once a week and developed a comprehensive exercise program for her to do herself at home with her family’s support. Slowly over the next few months the patient got stronger and her balance improved and she stopped having falls. Our physio slowly reduced the frequency of these sessions and now only sees this patient once a month to review things and check how things are going.

Elderly Mobility Case Study

Due to being a mobile physiotherapy service that sees our patients at their home or place of residence such as a care home many of our patients are elderly with reduced mobility. In this case study our patient is an elderly male normally resident in a residential care home in Sutton Coldfield who has just had a stint in hospital due to an infection and has been discharged to his care home. He was previously independently mobile around his care home in Sutton Coldfield but is now being hoisted as he is very weak. Contact was made by his son and one of our physios was able to visit the patient at his care home to conduct the initial assessment and his son was present as he wanted to understand what could be done to help his father. On assessment the patient was very weak and with a large amount of assistance from our physio was just about able to move very slightly up from a sitting position. It was agreed that in order to improve the patient’s mobility he would need substantial input and our physio started seeing the patient 2 to 3 times a week at his care home in Sutton Coldfield. Sessions initially concentrated on leg strengthening and getting the ability to stand again. Eventually after 3 or 4 weeks the patient was able to stop using the hoist and move onto a stand aid called a sara stedy which allowed him to pull up into a standing position. More sessions followed over the next month and the patient was eventually able to begin using a zimmer frame to transfer from bed to chair. After 3 to 4 months the patient was able to walk around the care home with a zimmer frame and was beginning to progress to using a stick. It is now approximately 6 months since our physiotherapist began seeing this patient and sessions are now weekly and the patient is able to use a stick to get around the care home but is not able to stop using the stick at present. It has been agreed with the patient and family that physiotherapy should continue on an ongoing basis so that the patient maintains his strength and mobility and doesn’t stop doing his exercises.

Conclusion

So, to summarise, what are some of the key features of these physiotherapy case studies? Well, firstly I think it is apparent that physiotherapy is vital and extremely helpful for our patients and that our physiotherapists being mobile and visiting them at home or in their care home is very beneficial. Secondly in cases where someone has a problem that is ongoing such as having had a stroke or being at risk of falls then ongoing physiotherapy can also be very helpful. Thirdly it is also important to get help as early as possible and that often the earlier help is sought the better the outcome.

Okay, I hope that you have found this article about physiotherapy case studies helpful. Should anyone you know need help with physiotherapy please get in touch and one of our physios would be happy to help. Just to remind you we are a home visit physiotherapy service and our physios are mobile and will come out to you at home and we serve areas such as Sutton Coldfield, Tamworth, Walsall, Lichfield and Cannock.

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