Case Study: Adult male brain injury and above the knee amputation

Referral & immediate needs assessment
- HCML instructed 5 months post accident – client inpatient at NHS neurological rehabilitation hospital ward
- NHS consultant advised it was unlikely the client would ever walk or carry out any day-to-day activities independently
- Cognitive impairments caused personality changes including understanding humour, poor concentration and memory as well as affecting speech and executive functioning – affecting family life
- Loss of function in left arm, limited neuromuscular control and discomfort in using prosthesis, so largely wheelchair bound
- Family home and car no longer suitable, and wife unable to provide the level of care the client required
- INA conducted within a week of referral
HCML support
- Arranged transfer from NHS to specialist residential rehab unit, within 3 weeks of being instructed
- Coordinated and maintained regular contact with NHS and private practitioners to ensure client received most suitable equipment and adaptations
- Organised osseointegration assessment to address socket discomfort
- Arranged MyoPro assessment for left upper limb, where the client was able to complete basic tasks with paralysed left hand
- Built strong relationship with client and family – organised psychological support for whole family
- Worked with family and professionals to secure new family home
Outcome
4 Months
Client was able to swim 20 lengths unaided, walk 10m unaided, walk 1km outside with single quad stick, walk up and down stairs using prosthesis and complete all activities of daily living independently
5 Months
Client took driving assessment and was deemed fit to drive with vehicle adaptations. HCML facilitated wheelchair accessible vehicle demonstrations and the client was driving unrestricted 14 months since the start of rehab.
13 Months
Client moved into new family home, supported by HCML.
14 Months
Client able to independently access local community with mobility scooter. Completed a 5k charity walk with HCML RCM.