Assessment in time


Related PT goals

Emerging problems during PT

0 weeks COPD GOLD I (2005)
­FEV1/FVC = 0.69
­FEV1 = 86% of predicted
­Dyspnea, MRC = 4/5
­Walking ≤ 10 min
­Never smoked
­Physical activity, 3x/week à not anymore
Diabetes type 2 (1998)
­No-proliferative retinopathy, lase eye-surgery in 2004 and 2011
­Sensory neuropathy in both feet
Obesity, BMI = 42.3 kg/m2 (2008)
Hypercholesterolemia (2008)
Severe osteoarthritis right knee, Kellgren-Lawrence score = grade 4 (2008)
Multiple falls per year
Reduce dyspnea, MRC < 4.
Improve mucus clearance.
Improve exercise capacity and physical activity in daily life, walk >30 min.
COPD exacerbations à prednisolone à weight gain à less eating à hypoglycaemiaà multiple falls. Combination COPD & DM à instable DM à interruptions in training programme and physical activity in daily life. Physical activityáà osteoarthritisáà work capacityâ and painá in knee. Total knee replacement ↔contraindicated by COPD & DMàdepression.
12 weeks* Dyspnea due to COPD, MRC = 4/5
3 COPD exacerbations / year
Walking ≤ 15 min
No weight loss, BMI = 42.3 > kg/m2
*Reassessment at 12 weeks; †Emerging problems during PT due to complex system interrelationships.
COPD: Chronic Obstructive Pulmonary Disease; GOLD I: Mild COPD; FEV1/FVC: Forced Expiratory Ratio; FEV1: % Forced Expiratory Volume in one second of predicted;
MRC: Medical Research Council Dyspnea scale; BMI: Body Mass Index; DM: Diabetes Mellitus
Table 2: Collected data and assessment data of case 2.
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