Case Study 2
Case study 1. Mr AM
Adam is a previously fit and well 32 year old Deputy Head & PE Teacher who was involved in a cycle-on-car accident on 26 April 2020. He sustained over 20 fractures, visceral injuries and a peripheral nerve injury (see graphic below). Adam spent 1 week in ICU and 6 weeks in hospital before his discharge home with weekly, remotely delivered physiotherapy sessions. Two months after his discharge he was assessed via a video call by the Remedy Healthcare clinical team. A recommendation for intensive, residential rehabilitation was made and Adam was subsequently admitted to the Kingston Rehabilitation Centre on 30 September 2020.
On admission, Adam was suffering from abdominal pain, low back pain, upper limb dysfunction, sleep disturbance and severely limited mobility. He was dependant on others for many activities of daily living and personal care tasks.
Adam spent 4 weeks undergoing a comprehensive, inter-disciplinary rehabilitation programme, with 73 hours of one-on-one clinical input during this time, including physiotherapy, hydrotherapy, occupational therapy, exercise rehabilitation instruction and medical supervision in a range of settings, both indoors and outside in the local community (see example timetable below).
On discharge, Adam commented “I can get into bed at night without even thinking about it for the first time since the accident!” and that “this is the best place for me to be to recover and I have the best team looking after me.” He demonstrated significant clinical gains across a wide range of formal, validated outcome measures (see chart below). Adam returned home with independence in all of his personal care and domestic tasks, and with greater confidence and exercise tolerance for external mobility and functional tasks.
Adam summarized his experience by saying: “I was incredibly excited to be given the opportunity to be taken into the Remedy rehabilitation programme when I heard about them. My experience and the progress I have made [during the intensive residential programme] has gone beyond all expectations. The staff of highly trained professionals made me feel like their number one priority and, by working with them I feel I have come a long way towards getting my life back.”
Less than 6 weeks after completing his residential rehabilitation programme and only 7 months after his index injuries, Adam returned to work as a teacher.
Adam’s case illustrates several important aspects of effective specialist MSK rehabilitation:
Timing & intensity of delivery of rehabilitation makes the difference – Adam underwent a period of high intensity, residential rehabilitation at a time when his dependency needs were high but his potential to benefit from physical therapy was optimum.
Residential rehabilitation with a high intensity, inter-disciplinary programme can deliver much improved outcomes than an equivalent number of community therapy hours spread out over a long period of time.
The combination of motivation & opportunity can deliver extraordinary outcomes – Adam was engaged and highly motivated throughout his recovery and was given access to the expertise & support he needed to achieve his goal of returning to work and ‘getting his life back’.