Acute Occupational Therapy Case Studies

Julia is a 43 year old female initially referred to acute occupational therapy due to a recent onset of symmetrical numbness, tingling, and weakness in her hands and feet. Julia reported having an upper respiratory infection two months prior and reports showing symptoms shortly after. Julia lives with her husband in Washington State and has two adult children who are out of the house and reside in different states. Julia initially only had numbness and tingling in the feet but over the past eight weeks has been progressing to her hand. Julia was fully independent two months ago and now requiring moderate to maximum assistance with activities of daily living (ADL’s) and is dependent for instrumental activities of daily living (IADL’s). Julia

Julia had no visual, cognitive, or verbal deficits that were discovered during the initial or reevaluation. Her primary deficits were as follows; limited sensation in hands and feet, primary weakness in the hands, trunk instability, limited trunk control, inability to stand, decreased activity tolerance, poor overall strength and little to no fine motor capabilities of the hands. Julia’s personal goals were focused on hand strengthening, independence in ADL’s and IADL’s, handwriting, and increase overall strength.
Due to Julia’s generalized hand weakness and personal goals it was determined to test her grip strength with the hand held dynamometer. According to Kolber and Cleland’s (2015), study the hand held dynamometer is a reliable and valid method to assess grip strength as long as the following guidelines are carried out 1) the tester as well as the device is stabilized; 2) the testing protocols are being carried out; 3) the device is perpendicular to the testing limb; 4) repeated measures are conducted with same device; and 5) appropriate trials are completed for accuracy. Julia’s grip strength was as follows:
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