Abstract
A 63-year-old female who was 2 weeks status post total knee arthroplasty underwent physical therapy for 12 sessions at an outpatient orthopedic clinic. The treatment was conducted by a student physical therapist under the direct supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with standardized outcome measures, including the Numerical Pain Rating Scale, Manual Muscle Testing, range of motion assessment, the Western Ontario and McMaster Universities Osteoarthritis Index, Timed up and Go, and Wells criteria for deep vein thrombosis. A plan of care was established to address impaired knee range of motion, reduced lower extremity strength, pain, reliance on a front wheeled walker, activity limitations as measured by the Western Ontario and McMaster Universities Osteoarthritis Index, and notable limitations in work-related activities.
The main goals for the patient were to achieve independent ambulation without assistive devices, improve balance to reduce fall risk, increase lower extremity strength to support knee function, decrease knee pain with activities of daily living, and successfully return to work.
Interventions included progressive therapeutic exercise for strengthening, task-specific functional training, balance training, and manual therapy to enhance joint mobility and reduce pain.
The patient achieved the following goals: significant reduction in knee pain, improved right knee range of motion, increased lower extremity strength, and improved functional mobility, including the ability to return to work. The patient responded well to physical therapy and was discharged with instructions to continue an independent home exercise program.