case presentation acl 1

7/23/2019 Case Presentation Acl 1

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Case presentation

Post Reconsrtruction

ACL InjuryBy: Nurdina afni izamudin

(031390) diploma fsioterapi

unisza



PHYSIOTHERAPY AX.

• Name:r. A

• A!e: "# years o$%

• Se&: a$e

• 'ate o( re(erre%:"). *une +,"-• 'ate o( A&.: ).Au!ust.+,"-

• 'r. : Lt. ACL tear an% meniscus injury

• 'r. &.:operatie/ post recon.01 2ee3s a!o4

conseratie/ re(er p5ysio



S67*ECTI8E A&.

• Pro9$em: pt. co 2ea3ness Lt.LL.

• Pain sca$e: NIL

2ea3ness



• Current H&.: 5o su%%en stop an%c5an!e %irection %urin! p$ayin!

(oot9a$$ since + years a!o. ;ra%ua$$yincrease pain a9out " 2ee3s an%2ent to H' t5en trans(er to HSN< on

t5e same %ay (or (urt5er m&. 'oneRI. 'r. %ia!nosis Lt. ACL tear an%meniscus injury. Pt. re(er (or ACLreconstruction. 'one reconstructionon *une +,"-. On 9races (or +2ee3s.'r. re(er 5im to p5ysio (or(urt5er m&.

• Past H&.: NIL



• Specia$ =uestion:

Occupation:Stu%ent

House: Sin!$e storey 5ouse current$y stay at 5oste$.

Toi$et: S=uattin!

• I&.:

X>rayme%icationRI

'one + years a!o 9e(ore recon.Resu$t: Lt ACL tear an% meniscus

injury.



• ?&. Actiity

pt. %i@cu$t to c$im9 up an% 2a$3in!

%o2n stairs.pt. (ee$ 2ee3 25en pro$on! 2a$3in!

an% stan%in!



O7*ECTI8ES A&.

• ;enera$ o9seration: A me%ium siea$ay a$e come to %epartmentin%epen%ant$y. Norma$ !ait. Norma$

posture.

• Loca$ o9seration:

re%ness

%ry s3in Lt. 3nee

s2e$$in!

ms. 2astin! at Lt. t5i!5



scar at ant. Part o( Lt. 3nee 0) cm4

%e(ormity at Lt.LL

open 2oun% at Lt. LL

9ruisin! at Lt. LL

• Pa$pation:

increase in 2armt5 at Lt. (oot

ten%erness Lt. LL



O7*ECTI8ES A&.


posture.


re%ness

%ry s3in Lt. 3nee

s2e$$in!




• RO: *t. ot. ARO 0 4 PRO 0 4

Rt. Lt. Rt. Lt.

Hip ?$e&.E&t.A9%.A%%.Int. rot.

E&t. rot.

A?RO

A?RO

Bn. ?$e&.E&t.

A?RO

A?RO

An3. 'orsie&.P$antare&.

InersionEersion

A ?

R O

A?

RO

A?

RO

A?

RO

A?RO o( 9i$atera$ LL.



• s. po2er

*t. ot. Lt. Rt.

Hip ?$e&orE&tensorA9%uctorA%%uctorInt. rotatorE&t. rotator

D-

D)

Bn. ?$e&orE&tensor D- D)

An3. 'orsie&orP$antare&orInersionEersion

D-

D)

ms. Po2er o( Rt. LL %t pro$on! immo9i$ise%



• s. !irt5

?romsuprapatte

$a

Rt.0cm4 Lt.0cm4 0cm4

8astusme%

ia$is 0)cm4

-+ F -

Gua%riceps 0", cm4

-) -+

Harmstrin! 0") cm4 - - -

ms. 2astin! o( Rt. t5i!5 %t $ac3 o( actiity



ANALYSIS

• Pro9$em i%entication:

". ms. Po2er o( Lt. LL %t pro$on!immo9i$ise%

+. ms. 2astin! o( Lt. t5i!5 %t $ac3 o(actiity

. ?unctiona$ actiity %t ms.2ea3ness.



• S5ort term !oa$

". ms. po2er o( Lt.LL 2it5in )+

+. ms. 2astin! o( Lt. t5i!5 2it5in )+



• Lon! term !oa$

". To re!ain (unctiona$ actiity

+. To maintain en%urance



PLAN O? TX.

". Stren!t5enin! e&s.+. *t. sense

. HEP

-. Pt. e%ucation



Interention

• Stren!t5enin! e&s.

• pt. sitt./ =ua% 9enc5 e&s. 0" 3!4 atLt. =ua%/ 3n.e&t./ 5o$% ", sec/ ")rept. J set.

• pt. 5i!5. sitt./ t5era9an% 0ye$$o24atLt.(oot/ %orsie&./ 5o$% ", sec/ ")rept.

•

pt.5i!5. sitt./ t5era9an% 0ye$$o24 atLt.(oot/p$antare&./ 5o$% ", sec/ ")rept.

• Cyc$in! e&s./ +,K.



• *t. Sense e&s.

• pt. stan%.on 2o99$e9oar%/ ")K.

• HEP

• ;ie e&s. pamp$et to pt.

•

As3 pt. to %o a$$ prescri9e e&s. at5ome

• Pt. e%ucation



E8AL6ATION

• pt. !ie cooperation to %o a$$ e&s.

• pt. (ee$ increase stren!t5 o( Lt. LL.

•

Pt. (ee$ $i!5t o( Lt. LL compare to9e(ore e&s.



RE8IE

• Reie2 ms. !irt5 o( Lt. t5i!5 on ne&tt&.

• Repeat interention on ne&t t&.

reie2



?o$$o2 up

• Name: r. A

• 'ate o( A&.: "#. Au!ust. +,"-

S: Pro9$em: pt. co 2ea3ness Lt.LL.



O7*ECTI8ES A&.


posture.


re%ness

%ry s3in Lt. 3nee

s2e$$in!




scar at ant. Part o( Lt. 3nee 0) cm4

%e(ormity at Lt.LL

open 2oun% at Lt. LL 9ruisin! at Lt. LL

• Pa$pation:

increase in 2armt5 at Lt. (oot

ten%erness Lt. LL



• RO: *t. ot. ARO 0 4 PRO 0 4

Rt. Lt. Rt. Lt.

Hip ?$e&.E&t.A9%.A%%.Int. rot.E&t. rot.

A?RO

A?RO

Bn. ?$e&.E&t.

A?RO

A?RO

An3. 'orsie&.P$antare&.InersionEersion

A ? R O

A?RO

A?RO

A?RO

A?RO o( 9i$atera$ LL.



• s. po2er

*t. ot. Lt. Rt.

Hip ?$e&orE&tensorA9%uctorA%%uctorInt. rotatorE&t. rotator

D-

D)

Bn. ?$e&orE&tensor D- D)

An3. 'orsie&orP$antare&orInersionEersion

D-

D)

ms. Po2er o( Rt. LL %t $ac3 o( e&ercise.



• s. !irt5

?romsuprapatte

$a

Rt.0cm4 Lt.0cm4 0cm4

8astusme%

ia$is 0)cm4

-+ #

Gua%riceps 0", cm4

-) - +

Harmstrin! 0") cm4 - --

ms. astin! o( Lt. t5i!5 %t $ac3 o( actiity



ANALYSIS

• Pro9$em i%entication:

". ms. Po2er o( Lt. LL %t $ac3 o(e&ercise

+. ms. 2astin! o( Lt. t5i!5 %t $ac3 o(actiity

. ?unctiona$ actiity %t ms.2ea3ness.



• S5ort term !oa$

". ms. po2er o( Lt.LL 2it5in )+

+. ms. 2astin! o( Lt. t5i!5 2it5in )+



• Lon! term !oa$

". To re!ain (unctiona$ actiity

+. To maintain en%urance



PLAN O? TX.

". Stren!t5enin! e&s.+. *t. sense

. HEP

-. Pt. e%ucation



Interention• Stren!t5enin! e&s.

•

pt. sitt./ =ua% 9enc5 e&s. 0".) 3!4 at Lt.=ua%/ 3n.e&t./ 5o$% ", sec/ ") rept. J set.

• pt. 5i!5. sitt./ t5era9an% 0ye$$o24at

Lt.(oot/ %orsie&./ 5o$% ", sec/ ") rept.• pt.5i!5. sitt./ t5era9an% 0ye$$o24 at

Lt.(oot/p$antare&./ 5o$% ", sec/ ")rept.

• S=uattin! e&s./ 5o$% ", sec/ ", rept. J set.

• Cyc$in! e&s./ +,K.



• *t. Sense e&s.

• pt. stan%.on 2o99$e9oar%/ ")K.

• HEP

• As3 pt. to %o a$$ prescri9e e&s. at5ome a!!rise$y.

• Pt. e%ucation



E8AL6ATION

• pt. !ie cooperation to %o a$$ e&s.

• pt. (ee$ increase stren!t5 o( Lt. LL.

•

Pt. (ee$ $i!5t o( Lt. LL compare to9e(ore e&s.



RE8IE

• Reie2 ms. po2er o( Lt. t5i!5 onne&t t&.

• Repeat interention on ne&t t& an%a%% more a!!ressie e&s.

reie2



RE?ERENCES

• 5ttp:222.sportsinjuryc$inic.net

• 5ttp:eme%icine.me%scape.com

• *o5n Cra2(or% A%ams/ 'ai%Ham9$en0"###4. Out$ine o( ?racturesinc$u%in! joint injuries/ E$eent5E%ition/ CH6RCHILL LI8IN;STONE.

case presentation acl 1

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