MT is a 24-year-old woman diagnosed with cerebral palsy (spastic diplegia) at age 3. She has a GMFCS Level 4 classification. M attended Vim Healthcare on August 3rd, 2023, for a neuro-physiotherapy review with the goal of joining our gym. She is focused on strengthening her lower limbs to improve mobility and has expressed a specific goal to walk down the aisle for her wedding next year.
History of Present Condition:
M was born as part of a set of twins at 32 weeks gestation, and both twins have cerebral palsy. She spent 2 months in NICU post-birth. M was able to crawl but did not cruise, and walked at age 4, exhibiting toe walking. She attended Chailey School and has had physiotherapy since a young age. She has used a Kaye walker and AFOs from age 4 and has been a wheelchair user since age 3. M has had no delays in speech development.
Initial Assessment Findings:
- Main Impairments:
- Lower limb spasticity
- Lower limb weakness
- Fatigue
- Reduced passive range of motion (PROM) in knee extension and plantarflexion
- Main Activity and Participation Limitations:
- Independent with most activities of daily living, with assistance from carers for heavy tasks such as housework
- Uses a powerchair for majority of mobility
- Transfers independently
- Can walk short distances with tripods and close supervision
- Currently studying at university
Treatment Plan:
MT plans to join the Vim Healthcare gym to access specialist equipment and exercise classes. She has been provided with advice for ongoing self-management and will be supported in her goals to functionally strengthen her lower limbs.
Previous Therapy Input:
- Physiotherapy throughout childhood
Equipment/Splints:
- GRAFOs (bilateral) for 5 years, awaiting an orthotics appointment at Brighton in the coming months
- Kaye Walker (not currently in use)
- Tripods (used with assistance from partner)
- Standing frame (can stand for 30 minutes)
- Ottobok Mollii Suit
- Shower chair
Input at Vim:
Over the course of 60 sessions = 45hrs, MT had 1:1 physiotherapy where she completed functional strengthening, treadmill training and was supported in the THERAtrainer Lyra and several other pieces of equipment.
She then supplemented her physio sessions by attending our gym twice a week.
During MT’s time at Vim she used the following equipment, some during 1:1 sessions others independently in her gym sessions
- Leg press
- THERAtrainer Tigo
- Easyglider
- Ottobok Mollii Suit
- Free weights
- Treadmill training
- THERAtrainer Lyra (for stretching and strengthening)
Outcome:
- Walk down the aisle for her wedding – Achieved
- Mobilising short distances with 2 tripods independently – Achieved
- Independently using the gym – Achieved
- Getting into partner’s bed via steps with more ease – Achieved
- Improving hip mobility and range of motion, including standing with legs further apart – Achieved
