Give me ICF model for this patient

Reading File

Running Command

cd /tmp/workspace/attachments/97774158-1d55-4fc7-925c-15a877a207af/ && python3 -c " from pptx import Presentation prs = Presentation('CASE PRESENTATION.pptx') for i, slide in enumerate(prs.slides, 1): print(f'=== SLIDE {i} ===') for shape in slide.shapes: if shape.has_text_frame and shape.text_frame.text.strip(): print(shape.text_frame.text) print() "

Now I have all the case details. Let me build a comprehensive ICF model for this patient.

ICF Model - Mr. Bachan Singh (77M, Recurrent CVA: Left Paramedian Pontine Infarct)

HEALTH CONDITION (Diagnosis)

Medical Diagnosis: Recurrent CVA - Left Paramedian Pontine Infarct with Acute Symptomatic Seizures Previous CVA: Left Median Temporo-occipital Lobe Infarct (2024)

1. BODY STRUCTURE & FUNCTION IMPAIRMENTS

Structural Impairments (b-codes)

Structure	Impairment
Left pons (ventral hemipons)	Acute infarct (MRI confirmed)
Left occipital lobe	Encephalomalacia with gliosis (prior CVA)
Periventricular & subcortical white matter	Ill-defined hypodensities (NCCT)
Right facial nerve (CN VII)	UMN facial palsy (House-Brackmann Grade I)

Functional Impairments

Domain	Findings
Motor	Right hemiparesis - flaccid tone in right arm; right hip ext. rotation, knee extended, ankle plantar flexed
Muscle strength	Reduced MMT across right UL and LL (details on slides 8-10)
Sensory	Right hemi-sensory loss
Speech/Language	Global aphasia pattern - poor spontaneity, fluency, naming, comprehension, repetition, reading/writing
Balance	Sitting: fair; Standing: poor; Balance reactions: poor
Coordination	Impaired (slide 9)
Cranial nerves	Right 7th CN UMN palsy
Consciousness/Cognition	GCS 15 (E4V5M6) - preserved
Muscle bulk	Wasting present
Seizure	Acute symptomatic seizure at onset

2. ACTIVITY LIMITATIONS

Activity	Limitation
Mobility	Unable to walk independently
Transfers	Dependent (bed mobility impaired)
Upper limb use	Poor reaching, grasping, and releasing (right hand)
ADLs	Fully dependent - bathing, dressing, grooming, feeding
Communication	Unable to communicate effectively verbally
Sitting balance	Fair - requires supervision
Standing	Poor - requires maximum assistance
Postural control	Poor balance reactions, cannot maintain standing independently

3. PARTICIPATION RESTRICTIONS

Domain	Restriction
Community ambulation	Unable to participate - confined to bed/ward
Social interaction	Severely restricted due to aphasia and immobility
Family role	Unable to fulfill role as elderly family member due to total dependence
Occupation	Retired/no occupation listed; homebound participation lost
Religious/cultural activities	Unable to participate due to physical and communication deficits
Self-care independence	Complete loss of independent living

4. CONTEXTUAL FACTORS

Environmental Factors

Factor	Facilitator (+) / Barrier (-)
Admission to Neuromedicine Ward, HIHT	✅ Facilitator - access to tertiary neuro care
Under active physiotherapy	✅ Facilitator - early rehab initiated Day 1
Good socioeconomic status (Kuppuswami scale)	✅ Facilitator - financial capacity for prolonged rehab
Physiotherapy & medical team collaboration	✅ Facilitator
Foley's catheter, Ryle's tube, IV cannula	❌ Barrier - restricts mobility and early ambulation
Home in Tehri, Garhwal (rural, hilly terrain)	❌ Barrier - difficult home environment for mobility post-discharge
Distance from tertiary rehab centre	❌ Barrier - limits follow-up and outpatient rehab

Personal Factors

Factor	Detail
Age	77 years - reduced neuroplasticity, slower recovery
Gender	Male
Comorbidities	Hypertension (25 yrs), T2DM (30 yrs) - increase infarct risk, impair healing
Past medical history	Recurrent CVA (2024) - pre-existing white matter disease
BPH Grade III / Prostatomegaly	Requires Foley's catheter
Alcohol history	Ex-alcoholic, abstinent 3 years - possible prior cerebellar/neurological effect
Dominant side	Right - affected side; greater functional impact on ADLs
Motivation/Attitude	Not explicitly noted
NIHSS	19/42 - Moderate to Severe stroke

ICF SUMMARY DIAGRAM

                    HEALTH CONDITION
         Recurrent CVA: Left Paramedian Pontine Infarct
                  + Acute Symptomatic Seizures
                           |
         ________________________________________
        |                  |                    |
BODY STRUCTURE       ACTIVITY              PARTICIPATION
& FUNCTION        LIMITATIONS              RESTRICTIONS
  IMPAIRMENTS
        |                  |                    |
 Right hemiparesis    Unable to walk       No community
 Flaccid right UL     Dependent ADLs       mobility
 Global aphasia       Poor hand            Severe social
 Right hemi-          function             isolation
  sensory loss        Poor standing/       Loss of
 R. UMN CN VII        sitting balance      family role
 Balance deficit      Cannot              Cannot
 Muscle wasting       communicate          communicate
        |                  |                    |
         ________________________________________
                           |
              CONTEXTUAL FACTORS
     ENVIRONMENTAL                  PERSONAL
  (+) Tertiary care access      Age 77, male
  (+) Active physio             Recurrent CVA
  (+) Good SES                  HTN, T2DM, BPH
  (-) External appliances       Right dominant side
  (-) Rural home environment    Ex-alcoholic
  (-) Distance from rehab       NIHSS 19 (mod-severe)

Key Rehab Priorities based on this ICF profile:

Prevent secondary complications (contracture, DVT, pressure injury) - given flaccid hemiparesis
Restore sitting balance - prerequisite for all functional tasks
Right UL facilitation (PROM → AROM → functional reaching)
Speech and communication rehabilitation (global aphasia)
Caregiver training - high dependency likely to persist given age + recurrent CVA
Discharge planning to accessible home environment given rural location

This is a shared conversation. Sign in to Orris to start your own chat.