Hi Fyzzio,

Thank you for your reply! There are no more lectures on this topic since my exam is postponed until September due to Covid-19. We have discussed a sample case study in class where my lecturer wrote an essay-style response for us to look at, which I can attach if appropriate.

Since your post I have looked a little more into the case study and started my next level of analysis. I also agree with Fyzzio and it would be great to have some discussion with other Physio students! This is what I have come up so far:

Patient Problem Subjective history that indicates this is a problem
1. Widespread muscle weakness - 4/5 oxford scale
- Increased resistance to PROM left LL – high muscle tone?
- Recent history of trips could be due to muscle weakness as well as balance and coordination?
- Reduced confidence 6/10 – especially caring for her children and performing ADL’s in the kitchen
- Difficulty getting up off the floor
- Ataxia
2. Problems with balance/decreased balance and coordination - Romberg test 40 seconds
- Feeling unbalanced like her right knee would give way after getting up from the floor
- Previous signs of ataxia, clumsy and shaking arm
- Recent history of trips
- Reduced confidence 6/10
- Wide BOS and problems clearing floor with left leg
- Hyperreflexia in L lower limb

I feel like this is a good start at formulating my thoughts and underlining problems in the case study. I would love to have everyone's opinion on my notes so far, and whether anyone else could see any other problems for the list? I am still thinking about problems with her gait as a potential problem, however I am unsure if this fits in with balance or co-ordination or whether it would be it's own separate problem?

Many thanks.