Abstract
A 44-year-old African American female with Class 2 obesity and a complex medical history involving 2 heart valve replacements, heart failure, and a hemorrhagic stroke, was admitted to an acute care facility with complaints of burning pain caused by the dislodgement of a feeding tube. Due to her recent medical issues, the patient had been entirely confined to bed and immobile for 6 months prior to this hospitalization. Physical therapy was administered by a physical therapy student under the guidance of a licensed physical therapist. The patient was seen for 12 sessions over 22 days. Outcome measures, including the Activity Measure for Post-Acute Care (AM-PAC), modified 30-second Sit-to-Stand (m30STS), and Function in Sitting Test (FIST), were used to identify the patient’s impairments of reduced strength, balance, and activity limitations of functional mobility and seated balance. Gait speed was used to measure limited community participation. The plan of care focused on improving bed mobility, sit-to-stand ability, transfers, balance, and gait. Interventions incorporated task-specific functional training, neuromuscular reeducation, over-ground gait progression, and structured practice of functional tasks. The patient responded positively, demonstrating measurable improvements in strength, functional balance, sit-to-stand performance, and bed mobility. By discharge, the patient achieved increased independence to discharge home with a home exercise program and home health physical therapy. This case illustrates the value of individualized PT and the potential for recovery that can be achieved despite medical complexity, profound deconditioning, and obesity.