TUT P

BRAVO factors

B = beweging

R= roken

A= alcohol

V= voeding

O= onstapping (relaxation)

Case study week 1

PT anamnesis - ICF (week case 1)

Request for help: be less short of breath during ADLs

Impairments

  • feeling unwell for years

  • short of breath

  • Diagnosis: Pneumonia, GP prescribes antibiotics

Activity

  • during extortion

  • walking: 300 m in 7 minutes - catch the bus (walking to the bus station)

  • feeling extortion after and during coughing

Participation:

- — -

Personal factors:

  • 41 years old, male

  • PT didn’t exercise for years

  • smokes cigarette (10 x day, for 20 years) tried to stop but failed

  • gained 5 kg

  • problem sleeping → smokes

  • coughed phlegm after taking his antibiotics

  • in his free time, he writes children’s stories

  • Body weight: 90 kg, height 165 cm

Environmental factors

  • support system → wife

  • works in an accountant firm

Clinical measurements

  • BORG dyspnoea: 6

  • BORG fatigue: 7

  • NPRS: 2 when coughing

————

Metabolic syndrome: when people have a little bit of everything (not to worry for GP because there is everything but low, but the combination of many little factors might be problematic)

  • weight (cholesterol) + diabetes + blood pressure (might be elevated) + stress + smokes + drinks + blood sugar

COPD

  • FEV 1s / FVC → PT with COPD can only expire 60 to 70 % of EV instead of 80 - 90% in one second

For exam:

  • majority of them are referred

  • some anamnesis questions (similar to stroke PTs)

  • medicines?

  • ask about BRAVO factors

  • keep in mind the transtheoretical model

  • Goals based on activity level to improve quality of life (physical exercises to get active, strength training)

  • nothing wrong with MSK, but the activity level of PT is affected

we can apply: what, how, and why principles as well here → ask Jolanda