As a 20 year old adult, Gerard received a brain injury as the result of an attack with a broken bottle whilst in Australia. He received a horrific injury to the neck and this caused him to loose a lot of blood, which caused oxygen starvation to the brain.
Prior to coming to the First Step Therapy Centre, Gerard was in a wheelchair or a bed and had very low cognitive abilities and physical skills having received little therapy in the subsequent four years after his brain injury.
After eight hours of intensive therapy Gerard’s, overall muscle tone in his upper and lower limbs and trunk muscles had improved when compared to initial assessment. He was graded 3 minus as per the Ashworth scale. His neck control, right upper limb movement had improved during these sessions.
Gerard’s standing had improved with the help of bungee ropes and the Universal Exercise Unit. During the initial treatment sessions, he used to require a lot of support and he was stressed very soon after entering the exercise unit. He used to require the maximum manual support, but now he only needs very minimal support and his standing endurance has improved from 5 minutes to 20-30 minutes.
Even though his standing was very much supported at this stage, encouragement of active standing was expected to improve his proprioceptive (balance) and stereognosis (touch) sensation in his joints and also help in toning his anti-gravity muscles in his back and his legs.
Gerard has showed significant improvement in his muscle power in his left upper limb and both lower limbs. Still he is encouraged actively to contract his knee extensors in a high-sitting position by asking him to kick a Swiss ball. He is also encouraged when in a high-sitting position to improve sitting balance and muscle strength of his abdomen and trunk muscles.
He also has improved during mat activities like rolling, quadruped standing (on all fours), bridging to incite muscle contraction of his back extensors and pelvic floor muscles.
It is very important to mention that Gerard’s improvement is very slow due to his brain injury and the lack of rehabilitation services he received over the last 4 years.
Gerard is expected to show improvement in his sitting balance and standing balance in next few months with the help motor relearning and cortical retraining programmes. His rehabilitation includes proprioceptive retraining, mobility exercises, strength training to limbs, balance and vestibular training in the sitting and standing positions to be adopted.
After 44 sessions of intensive therapy, Gerard can now sit and stand by taking minimal support.
Gerard’s mother and family are very appreciative of the rehabilitation and treatment delivered by Goshi and Ramya. His mother says that Goshi has a very friendly nature and his knowledge regarding Gerard’s treatment is really impressive and would recommend Goshi for his rehabilitation and therapy services.
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