Believe it or not

Hey guys

I have an interesting patient at the moment on my neuro placement. The patient is a male with MS and has presented with a flare up of the condition. The main issue is that he reportedly collapsed and is unable to ambulate with a WZF due to L lower limb weakness. The other main issue is social and he does not have a home to be D/C to. On examination he is very inconsistent with strength testing 2/5 and sensation (no light touch or proprioception). He is however able to transfer to w/c I and ambulate in parrallel bars. I automatically thought that he was attempting to give false objective measures so that he would be able to stay in hospital longer. He continually had collapsing episodes while transferring or ambulating but never actually collapsed as he always caught himself ( definitely 5/5 strength to do that). The more support I provided the more he "collapsed". On discussion with my supervisor I was told that as a physio you are required to provide treatment to patients that have impairments so this patient had no sensation in the L leg apparently and 2/5 strength in quads but is was not functional so we decided to provide Rx but not to focus on impairment but play his own game on him and provide functional tasks like ambulation and never to pay attention to the L leg as this caused so called collapsing. This seemed to work very well as on initial Ax he was 2x max assist to transfer but 2 days later is amb indep with a w/s. Its a miracle!!!
So I guess the lesson learned is to listen to the patient but be aware of the full picture and be aware of patients who try pull the wool over students eyes. They are to be treated all with some empathy but not to play into the trap but to rather challenge them functionally and not focus on the aparrent impaiments.