Abstract
A 90-year-old non-ambulatory woman with left lobar bacterial pneumonia and multifocal infiltrates was seen for physical therapy treatment for 7 consecutive sessions over a 12-day hospitalization in the inpatient acute care setting. Treatment was provided by a student physical therapist under supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with chest examination, the modified Borg dyspnea scale, the numeric pain rating scale, manual muscle testing, the modified 30 second sit-to-stand, the activity measure for post-acute care, and the functional independence measure. Measures used for diagnostic testing included the Well’s criteria for deep vein thrombosis, and the geriatric depression scale short form 15. The activity measure for post-acute care was also used prognostically for predicted discharge destination. A plan of care was established to address her impaired pulmonary function, dyspnea, pain, functional strength, and functional mobility. The main goals for the patient were to reduce oxygen supplementation, improve activity tolerance, improve muscular and functional strength, progressively improve performance of functional mobility, and to regain independence to move about her room to sit by the window. The main interventions used included patient education, chest physical therapy, positioning to be seated upright, coordination of pain management, muscular and functional strength training, and basic functional mobility training. On discharge, her exertional dyspnea and functional strength significantly improved which indicated increased tolerance for activity and pulmonary function. She was discharged to her previous skilled nursing facility on day 12 of hospitalization at her prior level of function.