AHRR Activity Case Study, Physical Practitioners

Mrs Jaff
AHRR activity Physical Case Study

Details and diagnosis

Mrs Cynthia Jaff is a 52 year old cleaner (born on 19/05/1964) who is right
hand dominant and sustained a right shoulder injury on 19/03/2016
following prolonged overhead use of a squeegee.
Mrs Jaff was referred to you by her nominated treating doctor, Dr Lee (ph:
9222 4444). Dr Lee provided a diagnosis of rotator cuff tendonosis and the
following conclusions from an ultrasound investigation:
no evidence of cuff tear
moderate subacromial bursitis
moderate supraspinatus tendinosis.

Your first consultation with Mrs Jaff was on 01/04/2016 when she
presented with a two week history of right shoulder pain.

Her claim number is E45467 and the insurer is Case Study Insurance

You are now up to your 7th treatment session with Mrs Jaff on 13/05/2016
and are using the session to complete the first AHRR.

Your physical examination findings include:

full ROM of shoulder elevation but pain associated with shoulder
flexion and abduction above 90
range of motion for hand behind back was symmetrical to the level of
L2
Hawkins Kennedy test was positive.
rotator cuff strength was symmetrical between sides, although pain
was associated with resisted abduction from neutral on (R).
Mrs Jaff scored 9/40 on the Patient Specific Functional Scale for the 4
activities she reported most difficulty.

Mrs Jaff has no history of previous shoulder problems and reported she
was not seeing any other practitioners.

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AHRR Activity Case Study, Physical Practitioners

Capacity
Mrs Jaffs employer has provided you with a job description. A workplace
rehabilitation provider was involved early following the injury and a case
conference was undertaken.
Mrs Jaffs pre injury duties as a cleaner is for 40 hours per week (8 hours
per day, 5 days per week). The duties involve driving to clients, unloading
and loading equipment (up to 15 kgs) into work van, cleaning tiles and
windows above shoulder height for up to 15 minutes, sweeping and
mopping floor tiles, emptying bins and tidies, and vacuuming carpets.
At her initial consultation with you Mrs Jaff had not yet returned to work.
She was experiencing difficulties with some self-care activities
(shampooing hair) and was only able to do very light domestic chores at
home. Her initial certificate of capacity documents a lifting capacity of 2
kg below shoulder height and no lifting above shoulder height. Sitting and
standing capacities were unrestricted, although driving was recommended
to 10 minutes at a time.
Mrs Jaff is currently working full hours in alternate office based duties, with
a 5kg lifting capacity of the right arm below shoulder height and a
capacity for light cleaning/domestic duties at home above shoulder height
for 10 minutes at a time. Mrs Jaff would require assistance with
unloading / loading cleaning equipment. The NTD Dr Lee has increased
Mrs Jaffs driving capacity to 30 minutes.
Mrs Jaff and all of the support team has agreed that Mrs Jaff will undertake
the office based duties temporarily while recovering and upgrading to her
preinjury role. Although Mrs Jaff was initially quite fearful of aggravating
her shoulder with a return to work, she is now motivated to return to full
capacity with work, home and leisure activities.
During the course of treatment Mrs Jaff has reported that she enjoys
maintaining her home and that she is also a keen home renovator. She is
halfway through refurbishing their spare bedroom and would like to get
this completed by the end of August 2016.

Recovery Plan
The AHRR plan is to commence on 27/05/2016 and end on 30/07/2016.

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