Abstract
A 69-year-old female patient with bilateral hip osteoarthritis was seen in an acute care setting following a left total hip arthroplasty (THA) for a total of three sessions over the course of two days, commencing the day of surgery. The patient’s medical records indicated a five-year history of Parkinson’s Disease, controlled by medications. Treatment was provided by a physical therapist student under the supervision of a licensed physical therapist (PT). The patient was evaluated at the initial encounter with a numerical pain rating scale, goniometry, manual muscle test, Wells clinical prediction rule, 10-meter walk test and the activity measure for post-acute care. On evaluation, the patient presented with impaired range of motion, strength and pain that limited her functional mobility, gait and stair climbing. A plan of care was established to address the patient’s impairments, activity limitations and participation restrictions. The patient’s goals were to decrease her pain, walk with assistive device, increase her gait speed and return home safely with her husband. Main interventions utilized were bed mobility, transfer, gait and stair training along with post-operative THA range of motion and strength exercises. The patient responded well to physical therapy interventions, and demonstrated an increase in range of motion, functional mobility, gait speed and a decrease in pain. The patient achieved true improvements in passive hip flexion range of motion and gait speed, and clinically important improvement in pain. The patient was discharged to home with assistance from her husband, a home exercise program, and follow-up care with a home health PT.