1. This document presents a case study of a 19-year-old male who suffered an ACL tear and meniscus injury while playing football 2 years ago and underwent ACL reconstruction surgery 6 weeks prior.
2. On initial physiotherapy assessment, the patient reported weakness in his left lower limb. Objective assessment found muscle wasting and weakness in the left thigh and lower limb.
3. The patient's treatment plan focused on strengthening exercises, joint sense exercises, a home exercise program, and patient education to address the muscle weakness and wasting from prolonged immobilization following surgery.
1. This document presents a case study of a 19-year-old male who suffered an ACL tear and meniscus injury while playing football 2 years ago and underwent ACL reconstruction surgery 6 weeks prior.
2. On initial physiotherapy assessment, the patient reported weakness in his left lower limb. Objective assessment found muscle wasting and weakness in the left thigh and lower limb.
3. The patient's treatment plan focused on strengthening exercises, joint sense exercises, a home exercise program, and patient education to address the muscle weakness and wasting from prolonged immobilization following surgery.
1. This document presents a case study of a 19-year-old male who suffered an ACL tear and meniscus injury while playing football 2 years ago and underwent ACL reconstruction surgery 6 weeks prior.
2. On initial physiotherapy assessment, the patient reported weakness in his left lower limb. Objective assessment found muscle wasting and weakness in the left thigh and lower limb.
3. The patient's treatment plan focused on strengthening exercises, joint sense exercises, a home exercise program, and patient education to address the muscle weakness and wasting from prolonged immobilization following surgery.
1. This document presents a case study of a 19-year-old male who suffered an ACL tear and meniscus injury while playing football 2 years ago and underwent ACL reconstruction surgery 6 weeks prior.
2. On initial physiotherapy assessment, the patient reported weakness in his left lower limb. Objective assessment found muscle wasting and weakness in the left thigh and lower limb.
3. The patient's treatment plan focused on strengthening exercises, joint sense exercises, a home exercise program, and patient education to address the muscle weakness and wasting from prolonged immobilization following surgery.
Name:Mr. A Age: 19 years old Sex: Male Date of referred:15. June 2014 Date of Ax.: 5.August.2014 Dr. : Lt. ACL tear and meniscus injury Dr. Mx.:operative, post recon.(6 weeks ago) conservative, refer physio
SUBJECTIVE Ax. Problem: pt. c/o weakness Lt. LL. Pain scale: NIL weaknes s
Current Hx.: h/o sudden stop and
change direction during playing football since 2 years ago. Gradually increase pain about 1 weeks and went to HD then transfer to HSNZ on the same day for further mx. Done MRI. Dr. diagnosis Lt. ACL tear and meniscus injury. Pt. refer for ACL reconstruction. Done reconstruction on June 2014. On braces for 2 weeks.Dr. refer him to physio for further mx. Past Hx.: NIL
Special question: Occupation:Student House: Single storey house currently stay at hostel. Toilet: Squatting Ix.: X-ray/medication/MRI Done 2 years ago before recon. Result: Lt ACL tear and meniscus injury.
Fx. Activity pt. difficult to climb up and walking down stairs. pt. feel week when prolong walking and standing
OBJECTIVES Ax. General observation: A medium size Malay Male come to department independantly. Normal gait. Normal posture. Local observation: redness dry skin Lt. knee swelling ms. wasting at Lt. thigh
scar at ant. Part of Lt. knee (5 cm)
deformity at Lt.LL open wound at Lt. LL bruising at Lt. LL Palpation: increase in warmth at Lt. foot tenderness Lt. LL
OBJECTIVES Ax. General observation: A medium size Malay Male come to department independantly. Normal gait. Normal posture. Local observation: redness dry skin Lt. knee swelling ms. wasting at Lt. thigh
Dorsiflexor Plantarflex or ms. Power of Inversion Rt. LL d/t prolong immobilised Eversion
Ms. girth From suprapatte la Vastusmed ialis (5 cm) Quadricep s (10 cm) Harmstrin g (15 cm)
Rt.(cm)
Lt.(cm)
42
38
45
42
47
43
ms. wasting of Rt. thigh d/t lack of activity
(cm)
ANALYSIS Problem identification: 1. ms. Power of Lt. LL d/t prolong immobilised 2. ms. wasting of Lt. thigh d/t lack of activity 3. Functional activity d/t ms. weakness.
Short term goal
1. ms. power of Lt.LL within 3/52 2. ms. wasting of Lt. thigh within 3/52
Long term goal
1. To regain functional activity 2. To maintain endurance
PLAN OF TX. 1. 2. 3. 4.
Strengthening exs. Jt. sense HEP Pt. education
Intervention Strengthening exs. pt. sitt., quad bench exs. (1 kg) at Lt. quad, kn.ext., hold 10 sec, 15 rept. 3 set. pt. high. sitt., theraband (yellow)at Lt.foot, dorsiflex., hold 10 sec, 15 rept. pt.high. sitt., theraband (yellow) at Lt.foot,plantarflex., hold 10 sec, 15 rept. Cycling exs., 20.
Jt. Sense exs.
pt. stand.on wobbleboard, 15. HEP Give exs. pamplet to pt. Ask pt. to do all prescribe exs. at home Pt. education
EVALUATION pt. give cooperation to do all exs. pt. feel increase strength of Lt. LL. Pt. feel light of Lt. LL compare to before exs.
REVIEW review Review ms. girth of Lt. thigh on next tx. Repeat intervention on next tx.
Follow up Name: Mr. A Date of Ax.: 19. August. 2014 S: Problem: pt. c/o weakness Lt. LL.
OBJECTIVES Ax. General observation: A medium size Malay Male come to department independantly. Normal gait. Normal posture. Local observation: redness dry skin Lt. knee swelling ms. wasting at Lt. thigh
scar at ant. Part of Lt. knee (5 cm)
deformity at Lt.LL open wound at Lt. LL bruising at Lt. LL Palpation: increase in warmth at Lt. foot tenderness Lt. LL
Dorsiflexor Plantarflex or ms. Power of Inversion Rt. LL d/t lack of exercise. Eversion
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} 5
Ms. girth From suprapatte la Vastusmed ialis (5 cm) Quadricep s (10 cm) Harmstrin g (15 cm)
Rt.(cm)
Lt.(cm)
42
39
45
43
47
44
ms. Wasting of Lt. thigh d/t lack of activity
(cm)
ANALYSIS Problem identification: 1. ms. Power of Lt. LL d/t lack of exercise 2. ms. wasting of Lt. thigh d/t lack of activity 3. Functional activity d/t ms. weakness.
Short term goal
1. ms. power of Lt.LL within 3/52 2. ms. wasting of Lt. thigh within 3/52
Long term goal
1. To regain functional activity 2. To maintain endurance
PLAN OF TX. 1. 2. 3. 4.
Strengthening exs. Jt. sense HEP Pt. education
Intervention
Strengthening exs. pt. sitt., quad bench exs. (1.5 kg) at Lt. quad, kn.ext., hold 10 sec, 15 rept. 3 set. pt. high. sitt., theraband (yellow)at Lt.foot, dorsiflex., hold 10 sec, 15 rept. pt.high. sitt., theraband (yellow) at Lt.foot,plantarflex., hold 10 sec, 15 rept. Squatting exs., hold 10 sec, 10 rept. 3 set. Cycling exs., 20.
Jt. Sense exs.
pt. stand.on wobbleboard, 15. HEP Ask pt. to do all prescribe exs. at home aggrisevly. Pt. education
EVALUATION pt. give cooperation to do all exs. pt. feel increase strength of Lt. LL. Pt. feel light of Lt. LL compare to before exs.
REVIEW review Review ms. power of Lt. thigh on next tx. Repeat intervention on next tx and add more aggressive exs.
REFERENCES http://www.sportsinjuryclinic.net/ http://emedicine.medscape.com/ John Crawford Adams, David Hamblen(1999). Outline of Fractures including joint injuries, Eleventh Edition, CHURCHILL LIVINGSTONE.
