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Posterior Fossa Syndrome

Outpatient II

Initial Evaluation

Physical & Occupational Therapy

Subjective History

Chief complaints: impaired strength, balance, walking, standing.
Past therapy: IP acute care, OP, IP rehab.
Functional limitations: patient required supervision/assistance with all functional mobility and ADLs including bed mobility, transfers, gait, locomotion, and balance.
Activity history: previously in Grade 1, not currently attending school, received radiation therapy daily.
Strengths: family support, progressing function.
Considerations: daily therapies coordinated with radiation therapy.
Objective: decreased muscle tone, strength, ROM, control, endurance & function. Treatment Included: Therapeutic exercise, functional training, ADL, IADL, assistive technology education, and motor performance.
Goals: improve Katie's function, balance, sitting, standing, and walking.

Speech Therapy

Chief complaint: decreased speech production/voicing and cognitive impairments, patient was within normal limits previous to surgery.
Functional limitations: patient presented with an overall decline in speech production & cognitive function, uses single words in a whispered voice.
Strengths: able to eat by mouth, family support.
Goals/Expectation: patient will function as independent as possible and communicate independently with family & friends.
Findings: patient presented with overall weakness of oral/facial musculature and decreased speech production. Patient was unable to complete some cognitive tasks such as sequencing and following complex directions. Katie would imitate on command from father; she responded best to father, using spontaneous language with him only. She responded more spontaneously when given choices, however needed constant coaxing to initiate. Katie whispered mainly, but increased voicing per family report.

Katie received chemotherapy treatments intermittently, which involved hospital admission for approximately three days at a time; she did not receive therapy during these admissions.