Abstract
A 67-year-old patient status post right total hip arthroplasty was seen day of surgery for acute care physical therapy for 3 sessions in a 2-day episode of care. Treatment was conducted by a physical therapist student under the direct supervision of a licensed physical therapist.
The patient was evaluated at the initial encounter with the Numeric Pain Rating Scale, goniometry, the Activity Measure for Post-Acute Care “6 Clicks”, levels of assist for functional mobility, and the Wells criteria for deep venous thrombosis. A plan of care was established to address moderate to severe right hip pain, moderately impaired right hip flexion and abduction range of motion, moderately to severely limited functional mobility (bed mobility, sit to stand, gait, and stair negotiation), all of which restricted discharge on the day of surgery. Main goals for the patient were to reduce pain, increase hip flexion and abduction range of motion, decrease levels of assistance with functional mobility, improve gait, and negotiate stairs to allow safe discharge to home with her spouse. Interventions included task-specific functional mobility training, including stair negotiation, therapeutic exercises for range of motion and strengthening, patient education, and cryotherapy. The patient achieved the goals of improved hip flexion range of motion and decreased levels of assistance in functional mobility. The patient was discharged home post-operative day 1 with her spouse, a home exercise program, and a referral for home health physical therapy.