Communty

Based
Rehabilitation
 Monday
Visiting Villages: Bolvampatti
Santhegoundanpalayam
Thondamuthur
Dhaliur,MGR Nagar
Name: Mr .Gothandan
Age: 56/M
Place : Poolvampatti
Diagnosis : Old Recurrent CVA with R (Hemiplegia) MCA infract

Muscle Tone : Spastic

Therapy Goals :
Voluntary Muscle power 
 • To improve Relearning of
Right Left Movement patterns and retraining of
missing components
UL  • To Improve muscle tone
3/5 5/5  • To prevent tightness of joints
• To improve gait
LL 
 Long term
3\5 5/5  • To improve ADL
Speech : Aphasic  • To strengthen muscle
 • To improve speech
ADL : Assisted ADL  • To improve vocational skills
Gait : Hemiplegic Gait  Therapy
 Active assist exercise
 Pelvic bridging
 Weight bearing activities
 Hand function traing
 Gait training
 Irregular of doing exercise
 Patient expired
Soundarya
Age : 13 year old girl
Village: Sunthu Gounda Palayam
Diagnosis: Cerebral Palsy, Spastic type with low vision?
Muscle Tone Moderate Hypertonicity
Supine When the mother called her name she responds ,
listens to music from TV.
She tends to keep her lower limbs in a wind swept
position.
Prone She is able to lift her head up for 2 minutes at
times
Able to weight bare on arms when positioned and
maximum support
Sitting Needs maximum support in sitting when made to
sit. For few minutes.
Toiletting not toilet trained
Feeding : Has difficulty in swallowing, mother feeds her
semi solids and liquids in supine
Short Term Goals: To be able to chew and swallow in
sitting.
Toilet scheduling introduced.
Modification of wheel chair to fit the child
Long term goals, self feeding using assistive devices
Proper seating in the wheel chair
Indicating toilet needs using assistive devices
Himasri
Age: 6 years old female
Village : Thondamuthur
Diagnosis: Cerebral Palsy, Spastic type with intellectual disability?

Muscle Tone Moderate Hypertonicity

Supine When the mother called her name
she responds , listens to music from TV.
She tends to keep her lower limbs in a wind
swept position.
Prone She is able to lift her head up for 2
minutes at times
Able to weight bare on arms when positioned
and maximum support
Sitting Needs maximum support in sitting when
made to sit. For few minutes.
Toiletting not toilet trained
Feeding : Has difficulty in swallowing, mother
feeds her semi solids and liquids in supine
Short Term Goals: To be able to chew and
swallow in sitting.
Toilet scheduling introduced.
Modification of wheel chair to fit the child
Long term goals, self feeding using assistive
devices
Proper seating in the wheel chair
Indicating toilet needs using assistive devices
Shanthini
Age 13 year old girl
Village Thondamuthur
Diagnosis CP Diplegia

 Tone Moderate Spasticity Lower limbs, mild

spasticity upperlimbs.
 She needs support to make her sit, when
made to sit she sits long legged she is unable
to sit cross legged.
 Left upperlimb is better and she uses her left
hand for all activities
 She self feeds using her left hand.
 Dependent in grooming,
 She indicates toileting and mother has to take
her to the toilet.
 She is dependent in all other activities of daily
living.
 Goals,
 Short term goal
 Family and Shanthini to accept her abilities
 Wheel chair mobility.
 Long Term Goals
 House hold chores to be done independantly,
 Adaptation in the toilet to make her
independant
Name: Mr .Paul
Age: 41/M
Place : Thondamuthur
Diagnosis : CVA with Brainstem intact

 Muscle Tone : Splastic Therapy Goals :

 • To improve Relearning of
 Voluntary Muscle power Movement patterns and retraining of
Right Left missing components
 UL  • To Improve muscle tone
 • To prevent tightness of joints
4/5 4/5
 • To improve Blalace and
 LL coordination
4\5 4/5  • To improve gait
 Speech : Aphasic Long term
 • To improve ADL
 ADL : needs help  • To strengthen muscle
 Gait : Hemiplegic Gait  • To improve speech
 Balance and Coordination affected  • To improve vocational skills
Therapy
 Pillow roling tremor Present  Active assist exercise
 Forward reaching activites
 Weight bearing activities
 Frenakel exercise for balance and
cordination
 Standing balance training
Name: Mr .Natrajan
Age: 56/M
Place : Polvampatti
Diagnosis :t CVA with R (Hemiplegia) MCA infract

Muscle Tone : Splastic Achived goal: Speech is qiet improved, Gait

is improved
Voluntary Muscle power Right Therapy Goals :
Left • To improve Relearning of
UL 4/5 Movement patterns and retraining of missing
5/5 components
LL 4\5 • To Improve muscle tone
5/5 • To prevent tightness of joints
• To improve gait
Speech : Aphasic Long term
ADL : Assisted ADL • To improve ADL
Gait : Hemiplegic Gait • To strengthen muscle
• To improve speech
• To improve vocational skills
Therapy
Active assist exercise
Pelvic bridging
Weight bearing activities
Hand function traing
Pardhiksha
Age 16 year old girl
Village Dhaliyur
Diagnosis: Spinal muscular atropy

 She can assume supine,

 She is not able to roll over or come to
sitting by her self.
 When made to sit she is able to maintain
for more than an hour.
 She is able to sit on a wheel chair when
she is made sit on it.
 Hand functions are good, is right handed,
she is able to write and do craft activities
very well
 She is able to feed herself when served
And given to her.
 Grooming is done by her mother. She is
dependent in all her activities assists her
mother minimally
 Goals
 Short term goals, make many craft
activities and have a sale.
 Maintain, physical and emotional
development/abilities as long as we can
Name: Mr .Balasubramaniyam
Age: 32/M
Place : MGR Nagar
Diagnosis : RTa with Head injury ,Traumatic SCI c5-C6 intact (R) Patellardislocation
Grade 3 Pressure sore Present

Muscle Tone : Flaccid Therapy Goals :

Voluntary Muscle power Right • To improve Relearning of
Movement patterns and retraining of missing
Left components
UL 2/5 • To Improve muscle tone
2/5 Above B/L wristlevel Below wrist 0/5 • To prevent tightness of joints
LL 0\5 • To prevent pressure sore
0/5 • To prevent DVT
Speech : Normal Long term
• To improve ADL
ADL : Need help for ADL
• To strengthen muscl
• To improve vocational skills
Therapy
Passiv ROM exercise for B/L LE
Active assist exercise for B/L UeE
Passive B/l Calfsqueshing ,Passive
Ankle pumpexercise
High sitting encouraged
 TUESDAY Cases
Visiting villages : Kallipalayam
Sreenevasapuram
Highschool pudur
Pooluvapatti Camp
Name: Mr . Rengaraj
Age: 60/M
Place : Kallipalayam
Diagnosis : Old Recurrent CVA with L (Hemiplegia)

Muscle Tone : Splastic Therapy Goals :

Voluntary Muscle power Right • To improve Relearning of
Left Movement patterns and retraining
UL 5/5 of missing components
4/5 • To Improve muscle tone
LL 5\5 • To prevent tightness of
4/5 joints
Speech : normal
• To improve gait
ADL : Self ADL
Long term
Gait : Hemiplegic Gait
• To improve ADL
• To improve vocational skills
Therapy
Active assist exercise
Weight bearing activities
Hand function training
Name: Mr . Murugan
Age: 57/M
Place : Kallipalayam

Diagnosis : Old Recurrent CVA with R (Hemiplegia) (R) Cellulites present in ankle

Muscle Tone : Spastic Therapy Goals :

• To improve Relearning of
Hyper tonicity Movement patterns and retraining of missing
components
Voluntary Muscle power • To Improve muscle tone
Right Left • To prevent tightness of joints
• To improve gait
Long term
UL 2/5 4/5 • To improve ADL
• To improve vocational skills
LL 3\5 4/5 Therapy
Active assist exercise
Speech : aphsic Weight bearing activities
ADL : assisted ADL Hand function traing
Self PNF Streching
Gait : Hemiplegic Irregular of doing exercise
Gait
Name: Mr . Kumar
Age: 36/M
Place : Kallipalayam
Diagnosis : Traumatic Spinalcord injury (L4-L5)fracture dislocation Paraplegia
Pus discharged from the surgical site
Grade #3 Discupits sUlcer present

Muscle Tone : Faccid Therapy Goals :

• To improve Relearning of
Voluntary Muscle power Movement patterns and retraining of missing
components
Right Left • To Improve muscle tone
UL • To prevent tightness of joints
• To strengthen the
5/5 4/5 Upperlimbmuscles
LL • To improve proper position of
the patient and woundhealing
0\5 0/5 • To Prevent DVT
Speech : normal Long term
• To improve ADL
ADL : assisted ADL • To improve vocational skills
Gait : Not assesed Therapy
Passive rom toB/L LE
Strengthen exercise to B/L UE
Ankle and toe Movements
B/L Calf Pumbs
High sitting
Wheelchair Mobilization
Name: Mr .Arun Kumar
Age: 18/M
Place : Kallipalayam
Diagnosis : Anterior horn syndrome?? InjectionPalsy

Muscle Tone : Flaccid Therapy Goals :

Voluntary Muscle power Right • To strengthen the Muscle
Left groups
• To Improve muscle tone
UL 4/5
4/5
•
Long term
LL 4\5
• To improve ADL
3/5
• To improve vocational skills
Speech : normal
Therapy
ADL : self ADL
Gait : Hip Hiking gait Strengthen exercise to B/L
UE
Ankle and toe Movements
B/L Calf Pumbs
Pelvicbredgeing
Plan:
Vocational rehabilition
 Name: Mr . Padmanaban
Age: 78/M
Place : HighschoolPdur
Diagnosis : Old Recurrent CVA with L (Hemiplegia)

Deformity : Left Flexd Elbow and Knee Therapy Goals :

deformity ,Cellulites present over Left • To improve Relearning of
Movement patterns and retraining of missing
ankle components
• To Improve muscle tone
Muscle Tone : Splastic • To prevent tightness of joints
• To prevent DVT and pressure sore
Voluntary Muscle power Right Long term
Left • To improve ADL
UL 5/5 • To improve vocational skills
3/5 Therapy
LL 5\5 Passive range ofmotion exercise
Active assist exercise
2/5
Weight bearing activities
Speech : normal Hand function traing
ADL : need help B/Lankle Pump
Gait : Not able to asses Standing training
Vishnu
Age: 10 Year old boy
Village: Srinivasapuram
Diagnosis: Cerebral Palsy with intelectual disability ??
 Muscle Tone: Hypertonous
 Supine - He lies with lower limbs
in a wind swept position. He is
not able to roll over.
 He respond to sound and turns
towards the sound. Sudden noise
or jerks, triggers seizures.
 Prone - He is able to lift his head
up for five minutes and weight
bares on his forearms , when
positioned.
 Sitting- Able to sit without support
–side sitting for maximum five
minutes, when positioned to be
fed.
 Feeding – Fed in a chair can
chew solids and swallow slowly.
 Toiletting – Not Toilet trained.
 Short term goals –maintain
abilities range of motion
 Modify wheel chair, with
lapboard
 Time scheduling in toilet
training
 Long term goals -
 Sit comfortably in a modified
wheel chair with the required
modification,
 Self feeding
 Toilet trained indicates in his
own way.
Name: Mr . Moses
Age: 61/M
Place : Polvapatti
Diagnosis : Old Recurrent CVA with L (Hemiplegia)

Therapy Goals :
Muscle Tone : Splastic • To improve Relearning of
Movement patterns and retraining of
Voluntary Muscle power missing components
Right Left • To Improve muscle tone
• To prevent tightness of joints
• To improve hand function
UL 5/5 4/5 • To improve gait training
LL 5\5 4/5 Long term
Speech : normal • To improve ADL
ADL : sometimes need help • To improve vocational skills
Gait : Hemiplegic gait Therapy

Active assist exercise

Weight bearing activities
Hand function traing
B/Lankle Pump
Functional activity training
Name: Mrs.Smathi
Age: 36/f
Place : Polvapatty Camp
Diagnosis : TB Meningetis

Deformity : Left Flexd Elbow and Therapy Goals :

B/FlexedKnee deformity • To improve Relearning of
Movement patterns and retraining of missing
Muscle Tone : Hypertonicity components
Voluntary Muscle power Right • To Improve muscle tone
• To prevent tightness of joints
Left
• To prevent DVT and pressure sore
UL 5/5 • To improve transfer activist
3/5 Long term
LL 3\5 • To improve ADL
3/5 • To improve vocational skills
Therapy
Speech : normal Passive range ofmotion exercise
ADL : Assist adl Active assist exercise
Gait : Not able to asses Weight bearing activities
Hand function traing
B/Lankle Pump
Sitting training
Wheelchair Mobilization
Malarvizhi
Age 15 year old girl
Srinivasapuram
Intellectual Disability with difficulty in speech

 She is physically normal.

 She is independent in all her
activities in daily living, unable
to comb her hair.
 She assists her mother
minimally in house hold chores.
 She is able to write her name
and her brothers name.
 She has few behavior
problems, she hits her mother
at times
 Short term
 Behavior modification
 Pre vocational activities
Mahashri
Afe 8 years, girl
Village Kallipalayam
Diagnosis Hypotonia? Mild Intellectually disabled ?

 Tone Mild Hypertonia ? Flat foot?

 Physically near normal except feet our flat.
 Going to school studying in 4th standard
reversibility present while writing.
Understanding is poor.
 Toilet trained, Puberty has been attained
mother training her in management.
 Dressing and undressing independent, she
bathes by her self, needs assistance in
grooming, Does not wash clothes or does
any house hold chores.
 She watches TV most of the time.
 Short term Goal
 Psychological evaluation
 Time table to make her do house hold
chores.
 Pre vocational skills
 Long Term Goals,
 Functional literacy and vocational Training
Name: Mr. Ramasamy
Age: 58/M
Place : Kallipaayam
Diagnosis : Old Recurrent CVA with Balance and coordination affect Rt BK
amputation

Therapy Goals :
 Muscle Tone : Splastic
• To improve Relearning of
 Voluntary Muscle power Movement patterns and retraining of
Right Left missing components
 UL • To Improve muscle tone
4/5 4/5 • To prevent tightness of joints
 LL • To improve coordination
and balance
4\5 4/5
Long term
 Speech : mild aphasic • To improve ADL
 ADL : assist ADL • To improve vocational skills
 Gait : Circumduction gait Therapy
Active assist exercise
Weight bearing activities
Hand function traing
Forward reaching activites
Frenakel exercise
Abhinav
Age: 5 year old boy
Village: Srinivasapuram
Diagnosis : Dyskinetic type of Cerebral Palsy
 Muscle Tone: fluctuating more towards
hypertonia
 Supine - can assume tends to have
involuntary movements. Lies symmetrically
but when called he turns towards the
sound and asymmetry is seen
 Prone - He is able to lift his head up for 10
t0 15 minutes and weight bares on his
forearms. He is able to roll over to the sides
some times awkwardly.
 Sitting- Able to sit without support for two
minutes, when made to sit. He is trying to
reach out to grab objects.
 Feeding – Fed in a chair can chew solids
and swallow slowly takes about 15
minutes.
 Toiletting – Time scheduled.
 Short term goals--Sitting comfortable on a
wheel chair
 Modify wheel chair, with lapboard
 Some form of indication in toiletting
 Long term goals -
• Sit comfortably in a modified wheel chair
with the required modification,
• Self feeding
• Toilet trained indicates in his own way.
Name: Ms.Valantina
Age: 5/f
Place : Polvapatty Camp
Diagnosis : Spina Bifida
Deformity : Lack of sensation overB/L Metatrasal region
Lackofsensation over Bowl and Blader

Muscle Tone : Hypotonicity Therapy Goals :

• To improve Relearning of
Voluntary Muscle power Movement patterns and retraining of missing
components
Right Left • To Improve muscle tone
UL • To prevent tightness of joints
• To improve walking pattern
5/5 5/5
• To improve Sensation
LL Long term
4\5 4/5 • To improve ADL
• To improve vocational skills
Speech : normal Therapy
ADL : sometimes needhelp Active assist exercise
Weight bearing activities
Gait : hiphiking gait Gait training
Goals achived
Independent walking now the child
went to school
 Wednesday visit
Visiting villages: Perur cettipalayam
Arumugagoundnur
Kallampalayam
Theethipalayam & Karadimadai
Name: Mr . Selvaraj
Age: 41/M
Place : Karadimadai
Diagnosis : CVA with R (Hemiplegia)

Muscle Tone : Hypertonicity Therapy Goals :

• To improve Relearning of
Voluntary Muscle power Movement patterns and retraining of missing
components
Right Left • To Improve muscle tone
UL • To prevent tightness of joints
• To improve hand function
3/5 5/5
• To improve gait training
LL Long term
4\5 5/5 • To improve ADL
• To improve vocational skills
Speech : Apasic • Speech therapy
ADL : Assist adl Therapy
Active assist exercise
Gait : Hemiplegic gait Weight bearing activities
Hand function traing
B/Lankle Pump
Functional activity training
Gait training
Goals achived: Griping and grapsing power
on right hand is improved well
Name: Mr . Rengasamy
Age: 56/M
Place : Karadimadai
Diagnosis : CVA with R (Hemiplegia)

Muscle Tone : Hypertonicity Therapy Goals :

• To improve Relearning of
Voluntary Muscle power Movement patterns and retraining of missing
components
Right Left • To Improve muscle tone
UL • To prevent tightness of joints
• To improve hand function
3/5 5/5
• To improve gait training
LL Long term
3\5 5/5 • To improve ADL
• To improve vocational skills
Speech : Apasic • Speech therapy
ADL : Sometimes need help Therapy
Active assist exercise
Gait : Hemiplegic gait Weight bearing activities
Hand function traing
B/Lankle Pump
Functional activity training
Gait training
Name: Mr . Sivanantham
Age: 38/M
Place : Kallampalayam
Diagnosis : CVA with R (Hemiplegia)

Therapy Goals :
Muscle Tone : Hypertonicity • To improve Relearning of Movement
Voluntary Muscle power patterns and retraining of missing components
• To Improve muscle tone
Right Left • To prevent tightness of joints
• To improve hand function
UL • To improve gait training
3/5 5/5 Long term
• To improve ADL
LL • To improve vocational skills
3\5 5/5 Therapy
Active assist exercise
Speech : Apasic Weight bearing activities
ADL : Assist Hand function traing
B/Lankle Pump
Gait : Hemiplegic gait Functional activity training
Gait training
Goals achived Speech is improved
Grapshing and picking object power is
improved
Name: Miss.Vismitha
Age: 3/F
Place : Thethepalayam
Diagnosis : Hypoxic encephlopathy

 Muscle Tone mild to Moderate Spasticity

 Supine assumes supine position tends to
bend towards the right side, scissoring
developing, reaches out at objects and
holds on for few seconds, Responds to
sound well. Vision appears good.
 Prone when called lifts up head, it tends
to wobble, in prone and can maintain for
five minutes.
 Sitting when made to sit, sits with weight
bearing on extended arms for few minutes
tends to bend to the right more.
 Toiletting not toilet trained
 Feeding : self feeding
 Short Term Goals: Improve sitting
balance,
 Introduced toilet schedule.
 crawling
 Long term goal
 Sitting on wheel chair with modification
 standing
Name: Mast.Praveen
Age: 18/M
Place : Kallampalayam
Diagnosis : Right Hemiplegia with MR

Therapy Goals :
Muscle Tone : Hypertonicity • To improve Relearning of
Voluntary Muscle power Movement patterns and retraining of missing
components
Right Left • To Improve muscle tone
UL • To prevent tightness of joints
• To improve hand function
3/5 5/5 • To improve gait training
LL Long term
3\5 5/5 • To improve ADL
• To improve vocational skills
Speech : normal Therapy
Active assist exercise
ADL : Assist adl Weight bearing activities
Gait : Hemiplegic gait Hand function training
Play therapy
Functional activity training
Special education
Sri saipandiswari
Age: 10years old female
Village : Perurchettipalayam
Diagnosis: CP Spastic type. Intellectual disability ?

 Muscle Tone mild to Moderate Spasticity

 Supine assumes supine position tends to
bend towards the right side, scissoring
developing, reaches out at objects and
holds on for few seconds, Responds to
sound well. Vision appears good.
 Prone when called lifts up head, it tends
to wobble, in prone and can maintain for
five minutes.
 Sitting when made to sit, sits with weight
bearing on extended arms for few minutes
tends to bend to the right more.
 Toiletting not toilet trained
 Feeding : solids and semi solids
 Short Term Goals: Improve sitting
balance, feeding solids
 Introduced toilet schedule.
 cr
 Long term goal
 Sitting on wheel chair with modification
 Self feeding
Name: Ms.Premalatha
Age: 26/f
Place : arumugagondanr
Diagnosis : RTA with head injury ,SDH

Muscle Tone : Hypertonicity Therapy Goals :

• To improve Relearning of
Voluntary Muscle power Movement patterns and retraining of missing
components
Right Left • To Improve muscle tone
UL • To prevent tightness of joints
• To improve hand function
3/5 4/5
•
LL Long term
3\5 3/5 • To improve ADL
• To improve vocational skills
Speech : Apasic Therapy
ADL : Need Major help Active assist exercise
Weight bearing activities
Gait : not asses Hand function traing
B/Lankle Pump
Functional activity training
Standing training
Suthish
Age: 5 years old male
Village : Armugam Koundanur
Diagnosis: CP Spastic type. Intellectual disability ?
 Muscle Tone mild to Moderate Spasticity
 Supine assumes supine position tends to
bend towards the right side, scissoring
developing, reaches out at objects and
holds on for few seconds, Responds to
sound well. Vision appears good.
 Prone when called lifts up head, it tends
to wobble, in prone and can maintain for
five minutes.
 Sitting when made to sit, sits with weight
bearing on extended arms for few minutes
tends to bend to the right more.
 Toiletting not toilet trained
 Feeding : semisolids and liquids are being
fed in sitting. slowly
 Short Term Goals: Improve sitting
balance, feeding solids
 Introduced toilet schedule.
 Long term goal
 Sitting on wheel chair with modification
 Self feeding
Naveen Kumar
Age : 2 years old
Village: Armugam Koundanur
Diagnosis: Developmental delay

 Muscle Tone normal mild extensor tone in

supine
 Supine assumes supine position, reaches
out at objects and holds on for 5 minutes,
moves by arching back in circles.
Responds to sound well. Vision appears to
be good.
 Prone when called lifts up head in prone
five to ten minutes. Prefers to be in supine
and tends to roll over to supine
immediately . Uncomfortable in prone
position
 Sitting bucket sitting on mothers lap with
minimnal support.
 Toiletting not toilet trained
 Feeding : semisolids and liquids are being
fed in sitting. Does not drink water.
 Short Term Goals: Improve sitting
balance, ablity to be sitting with out
support, come to sitting by self
 Introduced toiletting
Arockiamal
Age: 14 years old female
Village : Chennanur
Diagnosis: Intellectual disability ?

 She is able to sit walk and run. She does

not use her left upper limb, uses her upper
lims minimally as her hand functiions are
effected due to minimal hypotonia.
 She listens and to us and uses signs to
communicate. She has started to identify
all objects at home.
 She is able to undress and go to the toilet
but finds it difficult to wash herself.
 She needs help in bathing.
 She has attained puberty and mother is
training in self care and hygiene.
 She does not participate in household
chores and leisure time activities. All she
does is watch TV.
 Goals
 Independent in self help. And take active
part in house hold chores.
 Thursday
Visiting Villages : Paremashwaranpalayam
Pullagoundanpudur
Vellarukanpalayam
Viraliur& Naraseepuram
Name: Mrs.Saraswathi
Age: 60/M
Place : Parameshveranpaayam
Diagnosis : Old Recurrent CVA with L (Hemiplegia)

Muscle Tone : Splastic Therapy Goals :

• To improve Relearning of
Voluntary Muscle power Movement patterns and retraining of
Right Left missing components
UL • To Improve muscle tone
5/5 3/5 • To prevent tightness of joints
• To improve gait
LL Long term
5\5 3/5 • To improve ADL
Speech : normal • To improve vocational skills
ADL : Self ADL Therapy
Active assist exercise
Gait : Hemiplegic Gait Weight bearing activities
Hand function traing
Forward reaching activites
Standing training and gait
training
Name: Mr. Selvan
Age: 48/M
Place : Pullagounden pudur
Diagnosis : Old Recurrent CVA with Balance and coordination affect

Muscle Tone : Splastic  Therapy Goals :

 • To improve Relearning of
Voluntary Muscle power Movement patterns and retraining
of missing components
Right Left  • To Improve muscle tone
UL  • To prevent tightness of joints
4/5 4/5  • To improve coordination
and balance
LL  Long term
4\5 4/5  • To improve ADL
 • To improve vocational skills
Speech : normal  Therapy
ADL : Self ADL  Active assist exercise
 Weight bearing activities
Gait : Normal  Hand function traing
 Forward reaching activites
 Frenakel exercise
Name: Mr. Pattisamy
Age: 48/M
Place : Pullagounden pudur
Diagnosis : Cervical mylopathy?? Hansen disease?

Deformity : B/L Claw hand ,Lack of Therapy Goals :

sensation over R UL, Generlised
weekness
• To improve Relearning of
Movement patterns and retraining
Muscle Tone : Flascid
of missing components
Voluntary Muscle power Right
Left • To Improve Sensation
UL 4/5 • To improve coordination
4/5 and balance
LL 4\5
Long term
4/5
Speech : normal • To improve ADL
ADL : Need assistant ADL • To improve vocational skills
Gait : Normal Therapy
Active assist exercise
Sensory rehabitation
Frenakel exercise
Marathal
Age: 2 years old female
Village : Vellarikan palayam
Diagnosis: Developmental delay. Optic atropy
 Muscle Tone mild hypotonia
 Supine assumes supine position, responds
to auditory stimulation. Vision ?? To be
tested.
 Prone when called lifts up head in prone
momentarily.
 Sitting bucket sitting on mothers lap with
maximum support
 Toiletting not toilet trained
 Feeding : Has difficulty in swallowing,
mother feeds her semi solids and liquids in
supine
 Short Term Goals: To be able to be fed in
sitting.
 Head control.
 Sitting
 crawling
 Long term goals
 Walking without support
Name: Mast.Krishnamorthy
Age: 16/M
Place : Vellarukanpalayam
Diagnosis : Duschene Muscular dystropy

Deformity : Generlised Therapy Goals :

weekness,Muscle weekness • To improve Relearning
Muscle Tone : Flascid of Movement patterns and
Voluntary Muscle power retraining of missing
Right Left components
UL • To Improve Sensation
2/5 2/5 • To improve Breathing
LL pattern
0\5 0/5 Long term
Speech : normal • To improve ADL
ADL : Need assistant • To improve vocational
Gait : Not able to asses skills
Therapy
Breathing exercise
Hand function activites
Special education
Wheel chair
mobilization
Name: Mr . Venkatachalam
Age: 62/M
Place : Viraliur
Diagnosis : Old Recurrent CVA with L (Hemiplegia)

Muscle Tone : Splastic Therapy Goals :

Voluntary Muscle power Right • To improve Relearning of
Left Movement patterns and retraining
UL 5/5 of missing components
3/5 • To Improve muscle tone
LL 5\5 • To prevent tightness of
3/5 joints
Speech : normal
• To improve gait
ADL : Need help in sometimes
Long term
Gait : Hemiplegic Gait
• To improve ADL
• To improve vocational skills
Therapy
Active assist exercise
Weight bearing activities
Hand function traing
Transfer activites
Standing and Gait training
Name: Mr . Selvaraj
Age: 58/M
Place : Paremashwaranpalayam
Diagnosis : Parkinson Disease

 Chief complaints: B/L shoulder pain

 Frequent falls Therapy Goals :
 Muscle Tone : Splastic  • To Improve muscle tone
 • To prevent tightness of joints
 Voluntary Muscle power Right  • To improve Blalace and
Left coordination
 UL 4/5  • To improve gait
4/5 Long term
 • To improve ADL
 LL  • To strengthen muscle
4\5 4/5  • To improve speech
 Speech : Normal  • To improve vocational skills
 ADL : independent Therapy
 Active assist exercise
 Gait : Parkinson gait  Forward reaching activites
 Balance and Coordination affected  Weight bearing activities
 Pillow roling tremor Present  Frenakel exercise for balance and
cordination
 Standing balance training
 Tandem walking
 FRIDAY
Visiting village: Kalkottipathi
Permalkovilpathy
Ealuvaikal
Allandurai
Ambika
Age : 15year old girl
Village: Yelvaikal
Diagnosis: Cerebral Palsy, Spastic type with intellectual
disablilty
 Muscle Tone Severe spasticity both upper and
lower limb left more than right
 Supine Lie in supine with left LL in flexion.
Unable to rool to sides
 Prone does not assume and we are not able
to lposition in prone.
 Sitting Needs maximum support in sitting when
made to sit. For few minutes.
 Toiletting not toilet trained.
 Feeding : fed in lying down only liquids, unable
to swallow.
 Short Term Goals: To be able to chew and
swallow in sitting feeding technique
demonstrated. Sitting on mothers lap.
 Toilet scheduling introduced.
 Modification of wheel chair to fit the child.
Mother is making her sit on the chair in the
evenings.
 Long term goals, self feeding using assistive
devices
 Proper seating in the wheel chair
 Indicating toilet needs using assistive devices
Name: Mr . Lakshmanan
Age: 48/M
Place : PK Pathy
Diagnosis : CVA with R (Hemiplegia)

Therapy Goals :
Muscle Tone : Hypertonicity 
 • To improve Relearning of
Voluntary Muscle power Movement patterns and retraining of
missing components
Right Left  • To Improve muscle tone
UL  • To prevent tightness of joints
 • To improve hand function
3+/5 5/5  • To improve gait training
LL  Long term
 • To improve ADL
4\5 5/5  • To improve vocational skills
Speech : Mild Apasic  Therapy
 Active assist exercise
ADL : Self ADL  Weight bearing activities
Hand function traing
Gait : Hemiplegic gait 
 B/Lankle Pump
 Functional activity training
 Gait training
 Goals achived Speech is improved
 Grapshing and
picking object power is improved and
gait is improvrd
Name: Mr . Muniyappan
Age: 18/M
Place : PK Pathy
Diagnosis : Cerebralpalsy with MR

 Therapy Goals :
Muscle Tone : Hypertonicity
Voluntary Muscle power Right
 • To improve Relearning of
Left Movement patterns and
UL 3+/5 retraining of missing components
3/5  • To Improve muscle tone
LL 3\5  • To prevent tightness of
3/5
joints
Speech : NT
ADL : Needs Major help
Gait : NT  Long term
 • To improve ADL
 • To improve vocational skills
 Therapy
 Active assist exercise
 Passive range of Motion
exercise
 Wheel chair mobilization
 Special education
John Benjamen
Age 3 years old boy
Village: Allandurai
Diagnosis: Cerebral Palsy, Spastic type with intellectual disablilty ?
 Muscle Tone mild hypertonia
 Supine assumes supine position, mild
increase of tone. Visual regard ? Vision to
be tested. Hearing appears good
communicates minimally.
 Prone when called lifts up head in prone
five to ten minutes. Able to roll over mildly
awkwardly. Uncomfortable in prone
position
 Sitting bucket sitting on mothers lap with
minimnal support.
 Toiletting not toilet trained
 Feeding : semisolids are being fed in
sitting.
 Short Term Goals: Improve sitting
balance, ablity to be sitting with out
support, come to sitting by self
 Introduced toiletting
 Self feeding using assistive technology
Kasthuri
Age 3 years old girl
Village: Kalkuthipathy
Diagnosis: developmental delay t with intellectual disablilty

 Muscle Tone Mild Spasticity

 Supine can assume, tone mildly
increased, not very comfortable. Does not
reach objects, tends to throw object when
made to hold ( Hypersensitive). tries to sit
up.
 Prone does not prefer to lie in prone
tends to roll over. When put in quadruped
position weight bears on arms minimally
 Sitting when made to sit, sits well for long
periods of time.
 Toiletting not toilet trained
 Feeding : Fed in sitting.
 Short Term Goals: learn to sit by self,
 Standing with support from front.
 Hold objects by desensitizing
 Introduced toilet schedule.
 Long term goal
 Self feeding, indicate toilet needs, stand
and walk minimally