WEEK 1

13.10.08

DAY ONE, was mainly orientation based, familiarising us students at Bentley with the emergency proceedures, location of physiotherapy tools, introductions to other staff, standard proceedures etc.

We were given two patients to run through a 20 minute treatment session with. The two patients were infact husband and wife. The wife was admitted due to deconditioning secondary to dementia with an MMSE of 8/30, hypertension and her husband unable to care for her. When the wife was admitted the husband fell into depression and began to decondition also. Once reunited with his wife he recovered quickly, though it was decided that the best care for both patients would be to keep them together as her husband looks after her and takes alot of pressure off the nursing staff.

Our treatment session mainly targeted general strengthening and fitness as they did not have specific medical injuries or conditions that needed attention. Our supervisor hinted that with this level of cognitive impairement, demonstration and mimicing were the key to effective treatment. The husband joined in, and often corrected his wife and reminded her of things we had said (which was adorable). We then did a lap of the ward with their walking aids and returned to their room.

The strengthening exersices included UL exercises with weights (bicep curls, forward and upward punches) and LL exercises, targeting hip extensors, quads, ab/adductors, calf muscles and tib ant. We did a little bit of balance exercises and then functional activities were included by getting up from the chair to the parallel bars and walking around the ward with their aid.

Our supervisor told us we chose appropriate exercises and our instruction was appropriate for our patient. We didn't have time to prepare so were a little all over the place and not very structured which is something we could improve on for next time. We also didn't push our patients very hard and had them doing it quite easy which our supervisor told us we could push alot harder.

In the future i would structure the treatment and push the patient to near faigue to get the best outcome, challenge the system.

Today was quite a good exposure to the placement. An orientation to what we will be doing in the coming weeks which made me feel more confident in what we will be doing. We didn't do too much just got shown what to expect and the standard proceedure.