Queena's PT Progress March 2013

Dear Vanna,
 
I wanted to provide you some updates regarding Queena's progress. Reflecting upon her episode of care which began in November 2012 and ended in February 2013, I am able to report significant progress in Queena's abilities. I will highlight many of her achievements:
  
Sitting balance: When Queena started Outpatient PT with us in 2010, she had no observable righting response; that is, she was unable to control her trunk  balance at all. She was described as having "no trunk control" on the initial evaluation in 2010, unable of sitting erect and actually requiring total assistance of two people to even try this feat. Approximately a year ago, she had improved to a moderate assistance level with use of adaptive equipment to help her try to remain in a sitting position…However, now in 2013, Queena is now able to consistently sit up erect with minimal assistance of the therapist. Her posture is much improved and she is able to “right” self, consciously using her trunk and back muscles to raise up into a seated position. She is initiating rising up on her own and also upon cueing, demonstrating improved physical as well as cognitive skills.
 
Standing balance: In 2010, standing was not a possible goal. She was not physically able to even attempt that feat. We were simply trying to help Queena with building up her trunk strength and neck control so that she could try to sit up, raise her head or try to turn in bed... In 2011, she had built up her postural tone and trunk/neck strength to be able to stand up with maximum assist of two persons, starting first on a standing frame…Now, in 2013, Queena requires proper set-up but little cueing to rise to a standing position. She needs moderate-minimal assist to remain erect in a standing position, capable of making postural adjustments upon cueing and remaining in position for 10 minutes. She works extremely hard and is such a fighter! She is not yet able to take steps but this will be a future goal.
 
Mental/Cognitive status:Upon review of my reports in 2010, Queena was documented as not being to follow commands well or interact with the therapists.... In 2011 we noted that she had made significant improvements in this regard. Queena became quite interactive using non-verbal expressions (facial expressions, raising her arm or using her tone to move her body). She laughed at appropriate instances, often catching subtle humor.
 
In 2012 and now in 2013, Queena has proven to be even more and more interactive, laughing and smiling appropriately, recognizing staff members and is notably energetic! She listens intently to verbal commands and is able to kick ten times consecutively and without delay! Due to brain injury, one of the physical challenges that Queena faces is that her strong neurological tone makes relaxing her muscles difficult. However, Queena has been consistently able to relax this tone and be able to perform these consecutive repetitions! One of the biggest changes I’ve noted in Queena is her ability to respond to verbal instructions. The therapist asked Queena to wait until the cue word “pink” was given before she kicks. Decoy words were used but Queena waited, listening intently until the word “pink” was given in a monotone voice by the therapist. This really demonstrates that Queena is processing at a higher cognitive level! She kicked hard and then relaxed just as easily, re-coiling her leg for another nine repetitions!
 
Queena's injuries are significant and she has a long battle ahead. However, she never ceases to amaze me. I believe the Lord above is working in her! She has really made significant progress in the last year, especially in her ability to interact w/ others through non-verbal expressions, her ability to demonstrate an understanding of therapist’s instruction and her ability to control her tone and initiate purposeful movements consistently. Queena has the potential to achieve many milestones. I know she is working hard with the TheraSuit PT/OT treatment; last time she came back from that treatment, I noted some very significant improvements! Queena will need ongoing therapy to help her continue to make improvements. I feel strongly that she has been able to vastly improve her quality of life as well as her self-esteem: She is able to interact more with her environment and is able to improve her ability to control her muscles.
 
Thank you Vanna for your confidence in me. Queena is a remarkable young lady and is truly an inspiration to all of us!
 
Sincerely,
 
Heather



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