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Patient details is below: Diagnosis: Left middle cerebral artery cerebral vascular accident eight years post onset. History: The patient underwent an angioplasty and following surgery suffered a heart attack and a stroke. She was comatose for 21 days. Social: The patient is married. She enjoys gardening and sewing. She states she would like to work and has tried working at McDonald’s but this was too fatiguing for the hours that they wanted her to work. Prior to her CVA, she was a truck driver. There are no steps to her home. She has a scooter and uses it in the community, as she likes the freedom it gives her. She does drive a car. Additional Assessment Information: Right upper extremity: The patient reports she uses right arm and hand minimally in sewing and gardening, States she primarily uses her left upper extremity for activities of daily living. She was right hand dominant prior to CVA. Transfers: Independent in bed, toilet, and car transfers. She reports she does get assist from her spouse to transfer on a tub bench for showering. Ambulation: Ambulates independently in the home without assistive device. Short community distances are also independent without assistive device. States she uses a scooter for longer community distances. Reports she has never used an ankle foot orthotic (AFO). She reports she needs a railing or outside support on curbs, and stairs. Patient states she fell while gardening under low light and currently has bruises from this fall. She also reports falling is not a problem. Spouse adds that falling is not a problem unless she trips over her right foot. Assignment Questions: 1. Considering the ICF model, list two functional impairments and two activity limitations that V.H. experiences. 2. List one objective balance measure that you would use to measure fall risk in this patient. Why you choose that test? 3. What test would you use to help determine this person’s ability to be a community ambulator? Why? 4. What standardized test could you use to measure participation (as defined in the ICF Model) or quality of life? Why would you select this test? 5. Since it has been 8 years since V.H. had a CVA, speculate what types of secondary (indirect) functional impairments and activity limitations she might have acquired. Reading for this assignment is on attached file. Two Text book was for this assignment are 1. OSullivan, S.B., Schmitz T.J., & Fulk, G.d. (Eds.) (2013). Physical rehabilitation. (6th ed.). Philadelphia: F. A. Davis Company 2. Shumway-Cook, A & Woollacott, H. M (2012). Motor Control; Translating reasarch into clinical practice (4th ed). Lippincott Williams & Wilkins.



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