Unsteady Uproot – “Patient A and B” (Thursday, September 26th)

Patient “A” – Observation notes via therapeutic horseback riding. 1 hour. Supervised by DPT – Dr. L

Patient “A” is a 6 year old male presenting with Cerebral Palsy. Patient seems animated but not particularly alert in his surroundings. Patient must be supported at all times to remain upright. Physical Therapist’s (PT’s) initial comment is that the patient has not been stretch recently. PT believes the patients is not only tightening due to lack of consistent PT, but also experiencing contractures in areas throughout the body but particularly in the elbow and knee regions. PT is unable to part the patient’s leg forcing the PT to begin therapy with patient sitting on the horse sideways. Patient screams through entirety of riding lesson unless oral motor stimulation is applied via an electric toothbrush. Lesson is terminated when patient is asked not to bite the horse and patient bursts into tears. PT believes patient was experiencing sensory overstimulation and suggests to patient’s guardian a slower start for next lesson.

Goals for current therapy ride: work towards full extension of arms and legs.

Patient “B” – Observation notes via therapeutic horseback riding. 1 hour. Supervised by DPT – Dr. L

Patient “B” is a 7 year old female presenting with Cerebral Palsy. Patient’s guardian discusses seizure patterns and upcoming procedures with PT before patient begins therapy. Guardian reports that patient receives informal PT and speech therapy through a school program for 30mins every other week, but currently receives no OT at all. PT discusses with guardian the current goals for this therapy session. PT will use stirrups during patient’s ride to assist with balance. PT makes PT aid (self) aware of patient’s vagal nerve stimulator (upper right chest) and feeding tube button (lower abdomen) should an emergency dismount arise.

Patient “B” rides confidently with little assistance although she is currently favoring her left side. Patient’s stirrups were removed due to safety issues. Patient responded well to verbal cues and effectively communicated with therapy staff via a programable talking device.

Goals for current therapy ride: stay upright on horse. Maintain equal weight on left and right sides of horse.

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