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    DMD NON AMBULATORY Haho

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    florenciawirawan10

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    DMD NON AMBULATORY Haho

    Uploaded by

    florenciawirawan10
    25 views2 pages

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    Download as docx, pdf, or txt
    25 views2 pages

    DMD NON AMBULATORY Haho

    Uploaded by

    florenciawirawan10

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    DMD Non Ambulatory b. Hand function a.

    Galeazzi  LLD (bila positive) dan raba


    c. ADL greater trochanter
    ANAMNESIS d. Restriction in school/play/sport/leisure b. Thomas test
    1. Identity: sex, age, school 8. History of family illness Prone
    2. Chief complaint: 9. Psychosocioeconomy 14. Trunk look: deformity (scoliosis)
    a. Unable to stand / walk / ADL a. Environmental factor: family/caregiver, 15. Trunk Feel: tenderness, spasm
    b. Weakness home accessibility (toilet, stairs, wch access) 16. Trunk move: MMT trunk extensor
    c. Trunk deformity b. Personal factor: education, work, role 17. LE Move: MMT hip extensor, ankle plantarflexor
    d. Recurrent cough psychological problem, hope Sitting on the bed
    e. Easily fatigue 18. Functional mobility
    3. Symptoms of DMD: PHYSICAL EXAMINATION a. Supine to sitting
    a. Onset of weakness Supine-undressed 19. Sitting posture
    b. Weakness of LE: tip toe walking, often 1. General condition, Vital sign a. Trunk control
    falling, cant climbing stairs, cant 2. Nutritional status b. Posture anterior:
    standing 3. Visual/ auditory response c. Posture posterior: shoulder, scoliosis
    c. Gower sign: difficulty rising from 4. Communication: receptive, expressive d. Posture lateral: shoulder
    sitting, use hand and arms to hold on 5. Oromotor: Drooling, lipseal, buccal tone, tongue protracted/retracted, kyphosis
    the lower limb when try to standing and jaw movement, feeding 20. Special test: meryon sign
    d. Weakness of UE: cant rising the arm 6. Respiratory : breathing pattern, mouth 21. Hand prehension
    4. History of diagnosis/treatment breather, chest retraction, secondary breathing 22. Sitting balance: static / dynamic
    a. Biopsy/DNA/EMG/Lab muscle, auscultation (slem) 23. Chest expansion
    b. Drugs 7. UE Look: trophy (pseudohypertrophy deltoid), 24. Check out wheelchair
    c. Rehabilitation deformity a. Seat width 2 inch
    d. Home program: breathing exercise 8. UE Feel: tone, tenderness, spasm, sensibility, b. Seat depth 2 inch
    5. Complication ukur muscle belly deltoid c. Back height 2 inch
    a. Respiratory problem 9. UE Move : ROM (shoulder, elbow, wrist), MMT d. Seat height 4 inch
    i. Recurrent cough general (proks<distal) e. Arm rest height 1 inch
    ii. Fatigue 10. LE Look: trophy (pseudohypertrophy gastroc), f. Leg length 2 inch
    iii. Short of breath deformity (subluksasi)
    iv. Respiratory tract infection 11. LE Feel: tone, tenderness, spasm, sensibility, REHABILITATION PROBLEMS
    b. Deformitis: ukur muscle belly gastroc 1. Activity/participation:
    i. Scoliosis 12. LE Move: passive ROM a. Transfer/ambulation
    ii. Contracture a. ROM and MMT hip flexor b. ADL
    6. Associated problemcognitive problem b. ROM hip abduction, adduction c. Hand function
    a. Problem on learning at school c. ROM and MMT knee extensor d. Restriction in job/school/leisure
    7. Activity/participation d. ROM and MMT ankle dorsiflexion 2. Respiratory problem:
    a. Transfer/mobilisation/ambulation 13. Special test: a. Limited chest expansion
    b. Airway clearance problem
    c. Exercise intolerance
    3. Deformity: scoliosis, contracture
    4. Psychosocial problems

    REHABILITATION GOALS
    Short term
    1. Prevent further scoliosis: adaptive sitting device,
    flexibility exercise, proper positioning
    2. Maintenance of ROM: passive gentle muscle
    stretching

    Longterm goal

    1. Management of cardiorespiratory complication


    a. Regular evaluation of lung function:
    spirometry, MIP, MEP
    b. Breathing exercise:
    i. Incentive spirometry
    ii. Air stacking exercise
    iii. Deep breathing exercise
    c. Evaluation of risk of cardiomiopathy

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