Abstract
A patient with insidious-onset cervicalgia and prior history of whiplash injury was seen for student physical therapy treatment for 15 sessions over a period of 9 weeks at an outpatient physical therapy clinic under the supervision of a licensed physical therapist. The patient was examined at the initial encounter with the Numeric Pain Rating Scale, postural observation, inclinometry, universal goniometry, manual muscle testing, the deep neck flexor endurance test, and passive accessory intervertebral mobilizations. Patient-reported outcomes were measured by the Patient Specific Functional Scale and Neck Disability Index. A plan of care was established to address pain, decreased cervical range of motion and reduced strength and endurance of neck and scapular muscles, which had limited the patient’s ability to lift and carry items, look down to read, turn her head while driving, and participate in recreational swimming. Main goals for the patient were to reduce pain, improve mobility, perform activities of daily living related to lifting and carrying, and return to recreational swimming without discomfort. Main interventions used were manual therapy, electrostimulation, cryotherapy, motor control and endurance exercises, and patient education on posture, pain management, and activity modification. The patient achieved most goals and reported she was able to lift and carry items and drive without symptoms, and she returned to prior swimming participation with no pain. The patient was discharged to continue living at home for continuation of her home exercise program and self-management of symptoms.