Compose a 1500 words assignment on neurological case report. Needs to be plagiarism free! A C7 injury leads to paralysis of the extensor of the elbow (triceps), while the flexor of the elbow (biceps) and extensor of the wrist (extensor carpi radialis) is spared (Kirschblum, 2007). Rest of the upper limb and lower limb muscles. and bowel and bladder are involved. Features of upper motor neurone lesion with spastic paralysis develop. Additionally, in cervical cord injury there is autonomic system disruption in which there is unregulated sympathetic activity below the level of injury due to loss of cerebral regulation and unregulated parasympathetic activity above the level of injury (Kirschblum, 2007). Impact on Occupational Performance A spinal cord injury at the level of C7 has favourable projected motor outcome one year after the injury (Kirshblum, 2007). Although, occupational performance in most areas of the activities of daily living, vocational and leisure activities will be affected, the effect is likely to be minimal and patient is expected to become independent in most of these areas, with or without the use of adaptive equipment and technical modifications (Kirschblum, 2007). However, the patient may need assistance in a few activities from friends and family members. So far as activities of daily living are concerned, feeding, grooming, preparation of a light meal and upper extremity dressing can be autonomously performed. However, bowel and bladder care, lower extremity dressing and bathing requires assistance (Kirshblum, 2007). Vocational performance may be affected in the sense that wheelchair propulsion across rough surfaces and curbs requires aid (Kirschblum). However, in Philip’s case, because of the managerial nature of his job, vocational rehabilitation is likely to be very successful. Also, leisure activities that the patient used to perform prior to injury, namely gardening and sports will need modification in technique and equipment as appropriate because mobility and transfers need assistance and a wheelchair. Assessment of Component Skills Philip’s biomechanical and sensori-motor component of occupational performance needs assessment in context of the tasks that his job requires (Chapparo & Ranka, 1997). As a part of biomechanical assessment, upper limb movements need to be comprehensively evaluated. Muscle power, range of motion, weight transfer etc. are assessed. Shoulder movements, arm wrist and forearm extension and flexion are tested. Gross and fine coordination. and ability to write, hold objects of daily use and perform activities like dressing and grooming are assessed (Hoffman, Hannetona, Roby-bramia, 2006). In addition to motor evaluation, assessment of upper limb sensation as a part of sensori-motor component is important for rehabilitation program as it has been found to correlate with the recovery of motor power in future (Lightbody, 1998). Also, dynamics of social and psychological aspects of his interpersonal relationships and interaction with the family members need evaluation (Chapparo & Ranka, 1997). Prior to sustaining injury, he was actively involved in activities of his son and wife. Post injury, although his wife is assisting him in his daily activities, he doesn’t like her to play the role of a care giver. Physical aspects of marital life are also likely to be affected as a result of the spinal cord injury. Also, he may no longer be able to coach his son in his football practice.
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