Abstract
A 66-year-old female, self-employed housekeeper, 2 weeks status post (S/P) right shoulder arthroscopy, extensive debridement (of synovitis rotator cuff tissue and labrum), subacromial decompression, repair of supraspinatus tendon tear, and open biceps tenodesis, was seen for physical therapy for 15 sessions in 9 weeks at an outpatient orthopedic clinic. Care was provided by a student physical therapist under the direct supervision of a licensed physical therapist. Following the 15th session, the patient was discharged from the students’ supervision and continued therapy with the supervising physical therapist.
The patient was evaluated at the initial encounter with goniometry, manual muscle testing, the Numeric Pain Rating Scale, the Quick Disabilities of Arm, Shoulder, and Hand Questionnaire, the American Shoulder and Elbow Surgeons standardized assessment form, and the Patient Specific Functional Scale. A plan of care was established to address the patient’s moderate to severe right shoulder pain, severely impaired range of motion and strength, severe limitations with daily activities, and participation. A plan of care was developed with goals to improve range of motion, improve strength, increase tolerance of functional activities, and return to work.
Key interventions included passive range of motion, patient education, and progressive therapeutic exercise. Over the 9 weeks, the patient achieved increased range of motion, increased strength, improvements in daily activities, and returned to work on a smaller scale (smaller client base). The patient was expected to finish the remainder of her physical therapy and be discharged home to participate in an independent home exercise program.