Abstract
A 63-year-old male with squamous cell carcinoma of the lower lip, status post mandibulectomy with fibular free flap reconstruction to address subsequent osteoradionecrosis of the jaw was seen for student physical therapy treatment for 8 sessions over a 20-day stay at an urban hospital under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with 5 Times Sit to Stand, Activity Measure for Post-Acute Care (AM-PAC), 2-Minute Walk Test, gait distance, Tinetti Performance Oriented Mobility Assessment (POMA), and assist level for bed mobility and gait, and a plan of care was established to address: functional strength, range of motion, cardiovascular endurance, balance, gait, functional mobility, gait asymmetries, gait speed, and functional independence. The main goals for the patient were to become modified independent with bed mobility, transfers and gait with the least restrictive assistive device, show reduced fall risk on the POMA, complete an ear nose and throat home exercise program, and for the patient to become independent in directing his care. The interventions used were gentle active range of motion for the cervical spine and bilateral shoulders, and task-specific training for gait, bed mobility, balance, cardiovascular endurance, and transfers. The patient achieved the following goals: increased AM-PAC score and 2 Minute Walk distance and improved 5 Times Sit to Stand time. The patient was discharged to a skilled nursing facility.