Evaluation, Diagnosis, And Therapeutic Interventions

In the first session that was held with client Jane Smith it was to determine what the client was suffering from. Counselor agreed with community social worker that client exemplifies characteristics of Agoraphobia. The key characteristic that was identified in client’s behavior was that she does not leave her home. Client has a fear of being in public places. Client depends on her granddaughter to do all of her out of the home errands. After a multitude of characteristics were identified, intervention/treatment plan can be developed. Client alongside counselor will work together to develop an effective treatment plan. In reference to CBT a treat plan is “strategy between patient and therapist that gives direction to therapeutic process”. Client will be in charge of developing three goals that she will like to complete or work toward during sessions.

Today’s medical science makes available accurate identification of terminal illness, predictions of associated pain and suffering, as well as timeline towards diminishing quality of life. Method and accuracy of palliative prognostics in terminal illness is actively studied in the medical academic arena. Maltoni et al.’s 2012 study concludes survival probabilities using the Palliative Prognostic Score (PaP) method has been extensively validated resulting in high accuracy and reproducibility (p. 446). This greater understanding of life expectancy supports the means for a medical plan of action specific for the patient as defined by the patient, family, and physician. With acknowledgment of terminal illness,

Per medical report dated 01/23/15, the patient reported of middle and lower back pain and bilateral leg pain with tingling. He was diagnosed with thoracic compression fracture and lumbar spondylolisthesis.

ROM, pain level and strength were all improved on re-evaluation. Short-term and long-term goals were achieved. Treatment plan was to educate HEP, E-stim-unattended, Joint/Soft tissue mobilization, manual therapy, MHP/CP, neuromuscular re-education, Therapeutic exercise and strengthening-increase ROM, and Ultrasound.

Treatment plan includes saliva toxicology, lumbar MRI with and without contrast and lumbar back brace to provide symptomatic relief for chronic low back pain and to reduce pain by restricting mobility of the trunk and to support the weak spinal muscles. Goal is to facilitate healing of the lumbar spine.

Komblatt, the patient underwent extensive chiropractic treatment with 87 sessions from 10/07/11 through 07/11/12. It was opined that it does appear that the IW ha s undergone excessive passive-chiropractic treatment referable to both lumbar spine and right shoulder. It was further opined that the IW has reached MMI regarding the lumbosacral strain and contusion of the right shoulder within approximately 6-8 weeks post injury. Appropriate treatment would have consisted of aggressive right shoulder and low back rehabilitation to include aerobic conditioning, strengthening exercises involving the right upper extremity, lumbar spine and core, and resumption of normal recreational and work activities within 6-8

The patient was compliant to all aspects of treatment and the home exercise program. There are no known alternate explanations of the outcomes of this case report. However, in comparison to the case report by Caldwell et al25., the patient in this case report displayed a faster decrease in pain and return to normal function indicated by 0/10 VAS, 0% neck disability and ability to perform all tasks for work at the last day of treatment, 3 weeks from the first day of physical therapy. Possible explanations for the faster recovery could be due to the slight difference of impairments as well as the addition to grade IV and V manipulations to the cervical and thoracic spine as suggested to have high correlation with decrease in pain and normalization

The CSE training program (Therapeutic Intervention). This program will be modified from Jacob and colleagues (2014). It is designed for the intervention group to control and stabilize the spinal structures including deep muscle and spinal vertebrae for decreasing back pain and enhancing the physical function of the spine (Kim & Yoon, 2015; Shamsi, Sarrafzadeh, & Jamshidi, 2015). Therefore, the CSE training program could be described as the reinforcement of the ability to enhance the stability of the neutral spinal position. The CSE training program is a 4-week program including supervised exercise training and home-based exercise training. The core exercise of the CSE training program focuses on 3 components of spinal stabilities as following:

Anecdotally we know that relieving pressure on the discs via traction, non-surgical spinal decompression or inversion tables etc relieves the pain, we also know that continued activity opposed to inactivity is beneficial and everyone knows that stabilizing the spine and allowing strained muscles to relax and heal are critical to the healing process.

Williams admitted to 3D Physical Therapy where he was seen by Dr. Dana Helstowski. While treating at 3D Physical Therapy, Mr. Williams of continued to suffer from back pain, neck pain, and headaches. Mr. Williams presented a decreased cervical range of motion and a decrease in upper extremity strength, which were a cause of the muscle sprain along his entire back and possible instability/hypermobility of the upper cervical spine. Dr. Helstowski assigned Mr. Williams to skilled physical therapy for several weeks in order to undertake his impairments and help him return to his daily

Even with active assistance, the patient can only achieve approximately 140 degrees of forward elevation, 60 degrees of external rotation, and internal rotation barely to his upper sacrurn. He has 4/5 supraspinatus weakness and pain. Internal and external rotation strength seems to be normal. He has a nonspecifically painful Neer’s, Hawkins, and O’Brien’s test. His proximal biceps and acromioclavicular (AC) joint are both very tender to palpation.

good outcomes. The timely recognition of symptoms for this condition could be a matter of life

In other words, it can defined also as the series of questions the clinician ask to the client about each organ system or the body part during the first interview (history) and the physical examination to reach to the most appropriate findings about the client’s medical history and presenting illness. Example of the questions: the examiner can determine the history of fatigue, travel to other countries or the environment, any change in the lifestyles, any signs of fever or weight change. Moreover, the clinician can ask about the patient’s family; who live with the patient?, what is the patient’s relation with whom who s/he lives with?, and is s/he happy in his/her family?. Also can ask the patient about his/her hobbies and interest, does s/he have pets, does s/he exercise daily? And so

Conservative treatment are helpful in the early stage of the disease. Patients who are unfit or unwilling to undergo operative treatment, patient who are in plateau period without recent exacerbation, patients who present with new onset of subtle myelopathic findings and radiographic evidence of a soft disc herniation should undergo for preoperative evaluation, and these type of patient should undergo, physical therapy for gait training, occupational therapy for improvement of upper extremity dexterity, and neck immobilization with a hard cervical collar. Patient counseling about the possibility of symptomatic worsening and hazards of minor cervical trauma should be done. Follow up of patient every 6 to 12 months is done to look for neurologic function deterioration.

Assessment is the accurate collection of comprehensive data pertinent to the patient’s health or the situation (“American Nurses Association,” 2010). Assessment is the first step in the nursing process and the most important. Assessment is the accurate collection of the patient’s health date