CASE STUDY: BOATING ACCIDENT

Emily Coningham

Treating Therapist

Emily has over 15 years experience within all hospital clinical areas as well as community rehabilitation and management of chronic disease. She has extensive experience (10 years+) as a senior clinician mentoring junior physiotherapists, with seven of those years as a senior physiotherapist with Queensland Health.

BACKGROUND

Shaun sustained multiple injuries as a result of a boating accident

CONDITION

Elbow amputation and complete brachial plexus injury

TREATMENT

Mix of Physiotherapy & Occupational Therapy

SESSIONS

Twice Weekly (Occupational Therapy), Once Weekly (Physio)

OUTCOME

Meaningful improvement in both mental and physical state

Shaun developed significant upper limb lymphoedema following surgical removal of a sarcoma. Post-surgical changes to the lymphatic system resulted in persistent swelling, heaviness, and discomfort in his affected arm. This began to impact his ability to complete daily activities, including personal care, household tasks, and work-related duties. He was also at increased risk of skin breakdown and infection.

Challenges

Shaun experienced fluctuating swelling, reduced range of motion, and fatigue in the affected limb. The heaviness of his arm made sustained activity difficult, and he reported discomfort with movement. There were also concerns regarding skin integrity and risk of cellulitis due to ongoing oedema.

"Shaun was referred for both Occupational therapy and physiotherapy services for assistive technology, cognitive therapy, provision of exercises for both upper and lower body and social skills retraining."

Intervention

Shaun commenced a comprehensive lymphoedema management program, including:

Manual lymphatic drainage to support fluid movement and reduce swelling
Compression bandaging during intensive phases of treatment
Prescription and ongoing review of compression garments for long-term management
Education and implementation of a daily skin care routine to maintain skin integrity
Use of a pneumatic compression pump to support ongoing fluid reduction at home
Functional strategies to support safe and sustainable use of the affected limb

Outcome

Through consistent intervention, Shaun achieved a measurable reduction in limb volume and reported improved comfort and mobility. He was able to increase his participation in daily tasks with less fatigue and discomfort. Importantly, he developed the knowledge and skills required to independently manage his condition, reducing his risk of complications and supporting long-term outcomes.