Abstract
A 67-year-old male patient with acute lumbar radiculopathy was seen in physical therapy for 10 session over a 6-week episode at an outpatient physical therapy clinic. Treatments were provided by a physical therapy student under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with a Manual Muscle Test, range of motion measurements, segmental neurological examination, Lower Extremity Functional Scale, Oswestry Disability Scale, STarT Back Screening Tool, Slump Test, and Straight Leg Raise Test. The patient was identified to have signs and symptoms consistent with acute lumbar radiculopathy and a directional preference for extension. The patient reported concerns related to fear of movement. The plan of care was established to address the patient’s strength deficits of the core and hip musculature, active lumbar range of motion deficits, poor sitting tolerance, and high pain levels. The main goals for the patient were to improve his ability to sit for a duration longer than 15 minutes with no symptoms, improve strength in hip and core musculature, improve lumbar active range of motion, and decrease pain levels with all activities. The main interventions used were an extension-oriented treatment approach (EOTA), lumbar stabilization exercises, manual therapy, therapeutic exercises for strengthening of lower extremity and core musculature, pain education, and graded movement to address the patient’s fear concern. The patient achieved all goals set for physical therapy. The patient was discharged to home after 6-weeks of physical therapy with a home exercise program.