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Brian: PIP L Ring FingerJoint Injury "Would like to get AROM back…
Brian: PIP L Ring FingerJoint Injury "Would like to get AROM back ASAP"; right hand dominant
Occupational Profile
Client Report
Reason the client is seeking service and concerns related to engagement in occupations: client injured left ring finger PIP joint and it is very stiff. Client is experiencing decreased AROM.
Occupation in which the client is successful: Client is a successful student who makes As a business administration student. He is also successful in IM sports.
Personal Interests and values: Enjoys fraternity life and playing IM sports like basketball and frisbee golf with his fraternity brothers.
Occupational History: Client has no previous health issues besides seasonal allergies.
Performance Patterns
Routines
Brian walks to class Monday, Wednesday, and Friday mornings.
Brian generally does all of his school work on his laptop and completes exams for class using a pencil and scantron.
Two evenings a week, Brian practices and plays basketball with his IM team.
On the weekends, Brian likes to play frisbee golf or video games with friends.
Roles
Son, Student, Basketball Plater, Sibling
Habits
Completes homework on a laptop
Rituals
Client has lucky socks that he puts on before his basketball games
Enviroment
Physical supports & barriers: Brian lives on campus and is close by everything he needs.
Social supports & barriers: His fraternity house is close to campus and allows him to walk to school instead of worrying about driving.
Context
Cultural supports & barriers: Brian comes from a family of Longhorns who all play intramural basketball.
Personal supports & barriers: He is motivated in school and his motivation can help him in rehab.
Temporal supports & barriers: Brian is a young adult male, 19 years old and a student
Virtual supports & barriers: Brian loves texting and using social media on his phone and he experiences discomfort now. He also enjoys playing video games and he also feels discomfort holding the controller.
Client goals
Client's priorities and desired targeted outcomes:
Task Analysis
Student- Completing homework assignment
Brian does not have a consistent tempo or fluidity when typing.
Joint mobility is limiting his ROM to accurately punch keys on keyboard which is keeping him from finishing assignments in a timely manner
Positioning affects typing due to an extended L ring finger from stiffness
Endurance to fully complete assignments in one sitting is affected..
Frames of References / Occupation-Based Model
MOHO - This model will allow the OT to determine what motivates the client when choosing interventions.
Biomechanical - This frame of reference allows the OT to establish norms for range of motion and manual muscle testing goals. This will set a baseline for the OT to create interventions and goals.
Problem List:
Limited PROM/AROM for completion of functional activities, unable to effectively perform sporting activity
Pain management: Increased pain during prolonged typing
Increased edema prevents full ROM/ PIP extension and flexion
Limited strength for academic completion (writing, typing) and in-hand manipulation of school books
Stiff PIP limits grasp when carrying backpack
Assessments
ROM
AROM (Goni)- return to PLOF
PROM- incorporate stretch as prepatory method for AROM
QuickDASH - to address functional mobility problems
Pain scale
- decrease pain for increased participation and performance during occupational performance
Group members: Susan Shahsavari, Azi Vazin, Becky Dixon, Andrea Glaser, Rachel Sisneros, Sylvia Morales