Abstract
A 22-year-old male patient who was 6 days post-operative for a brainstem and cerebellar hemangioblastoma in the context of Von Hippel-Lindau disease was seen for physical therapy treatment for 11 sessions over 14 days in both a neurosurgical intensive care unit and inpatient acute hospital. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with vital sign monitoring, Numeric Pain Rating Scale, Physical Function Intensive Care Unit Test-Scored, modified Iowa Level of Assistance, and observation of level of assistance for bed mobility. A plan of care was established to address symptomatic orthostatic hypotension and limitations of strength, endurance, postural reactions, and low activity tolerance. Main goals for the patient were to regain independence with supine to sit, sitting at edge of bed, sit to stand transitions and transfers from bed to chair. A goal of recovery of gait under supervision with an assistive device was important to the patient, as well as the ability to return home. Main interventions used were counterpressure maneuvers for symptomatic orthostatic hypotension and task-specific functional training for the recovery of basic mobility. The patient showed some improvements in increased independence of bed mobility, sit to stand, transfers and ambulation, but continued to require physical assistance for out of bed activities due to persistent symptomatic orthostatic hypotension. The patient was discharged to inpatient rehabilitation.