Abstract
An 88-year-old female patient presented with closed displaced intertrochanteric left hip fracture from a ground level fall. She was seen at an acute care hospital for physical therapy 1 day post open reduction internal fixation of her femur. The patient was seen for 8 sessions over 11 days. A student physical therapist led the plan of care under the supervision of a licensed physical therapist. The patient was examined at the initial encounter with the Numeric Pain Rating Scale, Manual Muscle Testing, Iowa Level of Assistance Scale, Activity Measure for Post-Acute Care, and the Wells Criteria. A plan of care was established to address lower extremity pain with weakness, functional mobility limitations, and restricted ability to discharge home. The main goals of the patient were to learn ways to manage pain, progress walking distance, and to progress towards going home. Main interventions used were patient-related instruction on use of front wheeled walker, gait training, early ambulation, task specific training, and therapeutic exercise. The patient was able to demonstrate improvements with functional mobility but was unable to improve pain with mobility or progress walking distance sufficient to be able to be discharged home. The patient was discharged to a skilled nursing facility to continue her physical rehabilitation.