Success Stories


In these true case reports names have been withheld to protect patient privacy.


Articulation
Expressive Language

A 20 month old male was referred in July 2011 to speech and language therapy due to concerns with limited word use. At the time of the evaluation, the child communicated via gestures and sounds. He produced “da”, “mama”, “dacda” (for tractor), and animal sounds. He scored below normal for his age on the expressive language assessment.

Treatment: Communicative Temptations; Hybrid Approach; Manding (Verbal Behavior); Treatment techniques to carry over at home.

Progress: After three months of therapy, the patient was using spoken words (ball, up, down, no, go, shoe, outside, owl, yellow, open, off, on, fell down, yuck, trash, sure, hat, etc.). And he no longer used grunting as a means to indicate his wants. His reassessment determined that he was age appropriate for his age regarding expressive language and he was discharged from therapy.

Feeding

A 16 month old female was referred in September 2012 due to feeding issues regarding textures.

The patient was introduced to solid food at nine months, but she would respond by gagging and turning her head. At times, she would also cry, throw food, refuse to eat, and clamp her mouth shut. Her diet consisted of purees, such as yogurt and milk from a bottle. She would try to taste food by licking. Her doctor was concerned with her weight loss.

Treatment: Food textures were increased through Food Chaining – adding small amount of new textures to an acceptable food (yogurt). Oral Motor exercises were implemented to normalize allowable sensory input into her oral cavity. Strategies were also taught to parents for home program.

Progress: Within the first month of treatment the patient began attempting and eating new textures. By the second month she was eating various textures – from cookies, pancakes, corndogs, chips, chicken nuggets, and beyond. At her most recent doctor appointment, she had gained a pound.

Fluency

A 3 year, 9 month old female was referred for speech and language therapy in September due to concerns with her speech sound productions and instances of stuttering during conversation with accompanying secondary behaviors, such as eye blinks, tongue thrusting, and pursed lips.

The patient was approximately 50% intelligible with an unknown listener. She produced instances of stuttering when beginning to say phrases. She also had secondary behaviors, including blinking her eyes, protruding her tongue in an exaggerated manner, and averting her eyes. It was determined her stuttering was of moderate severity (17 words out of 200 word sample). Her speech sound errors were found to be severe.

Treatment: Indirect treatment of stuttering by modeling appropriate speech rate, allowing time for the patient to speak thoughts completely, and introducing parents to methods of indirectly assisting in treatment at home were all implemented into therapy.

Progress: Following three months of therapy, this child was able to speak fluently 80% of the time, while her stuttering is within a normal to mild severity. Her secondary behaviors are now non-existent apart from her habitual tongue thrusting during productions which will be targeted through articulation therapy.

Herniated Disc

A 30 year old female who was referred to Melanie Massey Physical Therapy with a diagnosis of Herniated Disc @ L5-S1. She was initially evaluated on 9/6/11, and was seen for a total of 7 treatment sessions.The patient presented at the evaluation with complaints of low back pain and radiating pain into the R lower extremity. She complained of (ncreased low back pain with prolonged sitting, tying her shoes, driving her car, and prolonged standing. Her score on the Oswestry Disability Questionnaire at the time of evaluation was 26.7%, which is classified as moderate disability. Clinically, she presented with increased low back pain & increased radicular right leg pain w/ trunk flexion, increased low back pain when testing leg strength as well as radiating pain into right leg.

Treatment: Manual therapy, mechanical traction, stretching, strengthening, posture/body mechanics training, HEP, pt. education, gait training, modalities, and balance activities

Progress: The patient met all of her goals with PT after 7 treatment sessions, including improved posture & body mechanics, independence with HEP, ‥ecreased lumbar neural irritability and increased tolerance of a full day of regular activities without pain.

Her score on the Oswestry Disability Questionnaire at the time of discharge on 9/26/11 was 4.4%. She was able to achieve her goals of resuming normal exercise without pain, tying her shoes without pain, standing and sitting for prolonged periods of time without pain, and driving her car without pain.

Please feel free to contact us if you should have any questions.

Knee Replacement

A 63 y/o female who had a Left Total Knee Replacement on 11/8/11. She was evaluated at Melanie Massey Physical Therapy on 11/17/11.This patient presented in the clinic at the time of the evaluation with (ncreased swelling and pain in her left knee, ‥ecreased strength and motion in the left lower extremity, and difficulty walking. She stated at the time of the evaluation that her walking, transfers, and squatting were limited due to her complaints.

Treatment: Manual therapy, modalities, stretching, strengthening, HEP, gait training, & balance exercises

Progress: The patient was seen for a total of 15 PT visits from 11/17/11 to 12/22/11. She was able to achieve 17/19 goals with PT before discharge, including improved motion in her left knee, normal strength in her legs, and normal walking without a walker or a cane.

She was able to progress from walking with a rolling walker to being able to walk without an assistive device. Mrs. H was able to achieve her personal goals of being able to walk around more for shopping without pain and being physically able to travel without pain.

Please feel free to contact us if you should have any questions.

Literacy

A five-year, seven-month old female was referred for speech and language therapy in November 2011 due to difficulty blending sounds into words, recognizing “snap” words at school, and reading.The patient displayed poor phonological awareness, vocabulary, grammar, and reading and writing.

Treatment: Shared Reading activities were included in instruction along with structured reading and writing tasks with emphasis on linking words to background knowledge and memorable experiences within the clinic setting.

Progress: After 6 months, she was able to read all age appropriate material provided without assistance. Her mother indicated per teacher’s report that she moved to the highest reading level within the class. She also made “A’s” on reading and spelling tests by the end of the school year.

Neck Pain

A 68 year old female who was referred to Melanie Massey Physical Therapy with a diagnosis of neck pain. She was initially evaluated on 9/28/11, and was seen for a total of 5 treatment sessions.

The patient had complaints of chronic neck pain for 17 years, which effected her sleep patterns and quality of life, and she had a cervical fusion surgery @ C5-6 & C6-7 over 10 years ago. At the time of the evaluation, Mrs. T also had complaints of headaches and radiating pain into her head, back, and bilateral upper extremities. She had complaints of severe neck pain and pain into her arm with washing clothes, house cleaning, and lying on her back. She presented in the clinic with ‥ecreased strength, decreased cervical motion,and muscle tightness leading to poor posture. Her score on the Neck Disability Index at the time of the evaluation was 56%, which is classified as severe disability.

Treatment: Manual therapy (including segmental cervical mobilization), stretching, strengthening, HEP, pt. education, modalities

Progress: This patient met all of her goals with physical therapy by 10/10/11, including (ncreased arm strength, increased range, and independence with home program. Her score on the Neck Disability Index at discharge was 8%, which is classified as WFL.

At the time of discharge, she was able to complete a full day of regular activity with no pain, including personal care, reading, work, driving, sleeping, and recreational activities.

Please feel free to contact us if you should have any questions.

Pelvic Pain

A 21 year old, newly married female with complaints of dyspareunia. She presented to physical therapy with pelvic floor pain and vaginismus. The patient is a nursing student with high anxiety in her work day.This patient had been married only a few months when she arrived to PT for her evaluation. Her chief complaint was an inability to tolerate intercourse at all. It had been almost 2 months since she had last had sexual intercourse with her husband. She reported an inability to tolerate penetration, therefore, could not engage in intercourse at all. Her report was “sharp” and on the left side, “Causing her to lose her breath”.

Treatment: Biofeedback to teach relaxation of pelvic floor muscles, education of positioning to better tolerate intercourse, a LE stretching program with down training of pelvic floor muscles, relaxation strategies, and manual therapy for internal trigger points

Progress: The patient was discharged on 04/05/12 after only four treatments. She was proficient with the use of dilators as a home program and could independently demonstrate her home exercise program. She reported very minimal pain (1/10) with initial insertion, but could complete the act of sexual intercourse pain free.

She was very pleased with her progress, and feels it greatly decreased the frustration not only she, but also her husband, was experiencing due to the pain. The primary goal was pain free intercourse, and this goal was met within one month of treatment, with only a single visit per week.

Please feel free to contact us if you should have any questions.

Sensory Processing Dysfunction

A 3 year old male was referred to Occupational Therapy services at MMPT with concerns of sensory processing deficits and behavior modification.At the time of the initial evaluation, the patient had issues with developmental play skills, had frequent meltdowns and temper tantrums, poor social skills, difficulty with transitions, below age level with pre-writing skills, and poor sensory regulation. He was only willing to participate in child preferred activities. He would demonstrate meltdowns and temper tantrum with all activities that were adult directed or structured. The patient was very sensitive to sensory input, as he avoided various tactile and auditory stimuli. He also demonstrated a very short attention to all tasks, and little to no attention to adult directed and structured tasks.

Treatment: Sensory Processing skills, behavior techniques, social skills, attention, developmental play skills, techniques to improve transitions, self-regulation, pre-writing activities, tolerance of ADL tasks, and compliance to adult directed tasks.

Progress: After only 3 treatment sessions this patient was able to transition from parents to therapist with no meltdowns and was able to transition between activities with ease. After 7 treatment sessions he no longer demonstrated emotional meltdowns or temper tantrums. He began tolerating various types of sensory input with little to no aversions. The patient has now mastered all prewriting tasks. He is learning to write his first name, alphabet, and numbers. He is now able to attend a daycare where he can easily function in all age appropriate tasks.

Sensory Processing Dysfunction

A 3 year old male was referred to MMPT due to his parents’ concerns about difficult behaviors and his inability to sit still long enough to complete a task. His parents’ main goal was for him to be able to attend a 4 year old preschool classroom (successfully) due to a previous child care facility dismissing him, because they were unable to meet his needs.

Following an OT evaluation, it was determined that he wasn’t processing sensory information appropriately.

Treatment: Auditory desensitization, vestibular and proprioceptive input with fun activities, and tactile stimulation. Therapy has also been focusing on functional skills such as manipulating scissors, identifying numbers, writing his name, and engaging in social play with similar aged peers.

Progress: He is now able to sit at a table-top and engage in activities until completion. He is also able to write his full first name independently. He has now not only met his parents’ goal of being able to attend a 4 year old preschool with other children, but has made advancements beyond his own age level in some areas.

Urinary Incontinence (Male)

A 65 year old male who presented to MMPT status post prostatectomy. His chief complaint was urinary incontinence since his procedure. He reported constant leaking requiring 4-5 pad changes per day. He reported his pads to be saturated, and he had virtually no awareness of when he was leaking. He was not producing a good urine stream because he was never able to allow his bladder to completely fill. He reported an inability to go fishing, do yardwork, or exercise without full urine loss. He had completely stopped participating in his favorite activity, fishing, due to the potential embarrassment.

Treatment: Biofeedback of pelvic floor muscles, specific muscular strengthening, education on diet/ bladder irritants, specific HEP

Progress: This patient received treatment 1 day a week for 12 weeks. He accomplished all of his short term goals originally set at the time of the evaluation. These include using fewer pads, mastering a home exercise program, decreased incidence of urinary incontinence by 90%.

He has resumed fishing with his friends, without fear of leakage and virtually no incidence of incontinence in social settings. At time of discharge from therapy, he was no longer dependent on pads for protection, saving him money, embarrassment, and liberating him to do more things with his children and grandchildren.

Please feel free to contact us if you should have any questions.

Urinary Incontinence (Male)

A 67 year old business man was referred to MMPT after having a prostatectomy. Patient reported that he started having significant issues with incontinence with standing activities after getting an infection 6 weeks after surgery. He reported leaking virtually every time he arose, when he walked, and especially when he descended stairs. His work requires him to ascend and descend stairs often, as well as walking around a showroom floor all day. He reportedly was changing 12-15 pads per day as protection to his clothes. His urge delay for urination was only 15 minutes, posing a problem in his job as a salesman.

Treatment: Biofeedback to teach pure contraction of pelvic floor muscles, home program to target pelvic floor muscles and the accessory muscles of his thighs and buttocks, stabilization of his lower abdominal muscles to improve isolation of muscle groups, and particularly to teach him appropriate breathing.

Progress: Over 2 ½ months, and only 6 visits, the patient went from fully incontinent to remaining totally dry during his work day. He went from 12-15 pads per day to only one “as insurance”. Also, he improved from fully saturated pads to a minimally damp one. He was discharged with the ability descend stairs and work a full day without fear of leaking. He reported, “I am better now than I was before the surgery.”

Please feel free to contact us if you should have any questions.


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Ruston

Shreveport

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