Abstract
A 56-year-old patient status posts a total knee arthroplasty was seen for 9 physical therapy sessions over 5 days at a rural hospital setting. Treatments were performed by a physical therapist student under the supervision of a licensed physical therapist.
The patient was evaluated at the initial encounter with 30 second sit to stand test, 10-meter walk test, Western Ontario and McMaster’s Universities Arthritis Index, Numeric Pain Rating Scale, Activity Measure for Post-Acute Care and Well’s Criteria for Deep Vein Thrombosis. A plan of care was established to address lower extremity weakness, limited knee flexion active range of motion, limited functional mobility, and restrictions in ability to discharge home. Main goals for the patient were to improve strength, range of motion, decrease pain, normalize gait, improve sit to stand transfers, stair climbing, and safe ambulation with an assistive device. Main interventions used were functional mobility training, gait training with assistive device, balance training, manual therapy, and a home exercise program. On discharge, the patient achieved the following goals: improvement in knee flexion and extension strength and active range of motion, 30 second sit to stand, functional mobility as analyzed by the Western Ontario and McMaster’s Universities Arthritis index and the activity measure for post-acute care, and improved independence with ambulation with assistive device. The patient was discharged to her home with outpatient physical therapy.