Abstract
A 73-year-old female patient with chronic bilateral knee osteoarthritis underwent physical therapy for 8 sessions over an 8-week period at an outpatient orthopedic setting. 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 using manual muscle test, goniometry, observational gait analysis, single leg balance, Ober test, Meniscal Composite Score, Body Mass index, 5 Times Sit-to-Stand, pain provocation tests, knee ligament laxity tests, 6-Minute Walk Test, Lower Extremity Functional Scale, Western Ontario and McMaster University Osteoarthritis Index, Knee Osteoarthritis Clinical Prediction Rule, and American College of Rheumatology Criteria – Knee Osteoarthritis. A plan of care was established to address bilateral lower extremity weakness, limited range of motion, knee joint line tenderness and crepitus. The primary goals were to improve strength and range of motion, improve walking capacity, improve ability to transition from sitting to standing, improve tolerance with ascending/descending stairs, improve tolerance for prolonged standing and sitting associated with driving, and increase ability to walk her dogs. Key interventions included manual therapy and therapeutic exercises. The patient responded positively to the physical therapy interventions, demonstrating moderate improvements in strength and range of motion, walking capacity, reduced fall risk and functional independence. The patient achieved the following goals: improved lower extremity strength, improved range of motion, reduced pain, and improved walking capacity. The patient was discharged back home with a home exercise program to maintain functional independence.