Case:
“The ClientDan Brown is a 47-year-old Mexican American who holds a master’s degree in recreation/sports management as well as a bronze medal in quad rugby from the Paralympic games. He lives independently with his wife and works for the facility. He has also written a book, co-starred in a movie, and is a disability advocate and public speaker. He enjoys participating in sports activities in addition to volunteering at his church and being an advocate in adaptive and competitive wheelchair sports. At the age of 9, Bob contracted a rare form of meningitis. To save his life, all four limbs had to be amputated. Dan uses prosthetic upper limbs to assist with dressing, driving, and activities as needed. He competes all ADLs independently.Dan comes to you, the intern at the training facility, to generate new ideas. Dan shares the following information from his background so you can begin brainstorming
Significant past medical history:
-Childhood meningitis resulting in amputation of four limbs.
-After amputations, Dan has had over 20 surgeries for skin grafts and plastic surgeries to reshape face and residual limb damage from the illness.
-Dan had a car accident, which resulted in the further amputation of the left residual limb.
-He also had a broken collarbone and minor hip fraction from this accident.
Medications: Claritin and multivitamin for men over 40.3.
Cognition/perception:
WNL4.
Physical examination
a. Sensation: Light touch pain at the end of all residual limbs. Phantom pain in amputated legs periodically.
b.ROM: WNL
c.Strength: Above normal limits. Can bench press 150 lbs.
d.Balance: WNL
e.Pain: Phantom pain lower limbs”
Mobility
a.Uses a Performax manual wheelchair, drives independently with hand controls.
Uses prosthetic arms for fine motor skills.
b.Transfers: Independently, including placing chair in car for driving
Client Goals
1.Continue playing competitive wheelchair sports: wheelchair rugby and tennis
2.Travel to places I’ve wanted to go; to Miami and Rome, Italy
3.To stay active in community and church community
4.Travel for book promotion
1. Create an inclusion plan for Dan Brown, using evidence-based practice to guide your decision on appropriate interventions following the DENT problem-solving method.
a. Define the problem: Clearly identify and articulate the specific problem or challenge that needs to be addressed. This involves understanding the current situation, desired outcomes, and any constraints or limitations (1 paragraph)
b.Explore possible solutions: Generate a range of potential solutions or approaches to solving the problem. Encourage creative thinking and consider different perspectives or alternative options.(1 paragraph)
c. Narrow down options: Evaluate the potential solutions and select the most feasible and effective ones. Consider the advantages, disadvantages, and potential risks associated with each option.(1 paragraph)
d. Take action: Implement the chosen solution or solutions. Develop a plan, allocate resources, and set specific goals and timelines for execution. (1 paragraph)
2. What assessment would be most appropriate for you to give to Dan (1 paragraph: Question 2 and Question 3)
3. What factors must be considered when planning Dan’s intervention?
4. What is your PICO question?(1 paragraph: Question 4 and Question 5)
5.What outcomes do you anticipate from your treatment plan?
6.How will you evaluate the outcomes of your treatment plan?(1 paragraph: Question 6 and Question 7)
7.What contraindications should you consider in Dan’s treatment?
8.What recreational activities would be appropriate considering Dan’s interests, goals, and current functioning level? (1 paragraph)
9.How would you communicate your recommendations to Dan?” (1 paragraph)