Abstract
A 77-year-old patient with cerebral seizures due to alcohol withdrawal syndrome was seen for physical therapy treatment for 24 sessions over eight weeks at a skilled nursing facility. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The patient’s deficits were categorized using the International Classification of Functioning, Disability and Health (ICF) Model. The patient presented with signs of cognitive impairment as measured by the Montreal Cognitive Assessment, diminished strength as measured by manual muscle testing, decreased range of motion as measured by goniometry, impaired balance and postural control as measured by the Mini-BESTtest, and moderate pain intensity as measured by the Visual Analog Scale. These body structure and function impairments contributed to deficits in activities including increased fall risk as measured by the Functional Reach Test, decreased bed mobility and transfers as measured by level of assistance required, and decreased walking distance and functional walking capacity as measured by the Six-Minute Walk Test. Activity limitations decreased his ability to participate in social activities and live at home with his family, as measured by the Falls Efficacy Scale International. Main goals for the patient were to be able to ambulate for prolonged distances and live at home with care from his family. Main interventions used were balance and postural control training through task-specific training, and over-ground gait training. The patient improved strength, range of motion, pain management, balance, and ambulatory skills. Ultimately, the patient was assigned to another physical therapist to continue physical therapy with the expectation to continue living at the skilled nursing facility, with increased participation in social activities and the ability to live at home with family supervision on the weekends.