Abstract
A 45-year-old female patient with a medical diagnosis of right knee osteoarthritis was seen for physical therapy for 10 sessions in a 6-week period at a private, physician owned, outpatient physical therapy clinic. Physical therapy care was provided by a physical therapist student under the supervision of a licensed physical therapist.
The patient was examined during the initial encounter using manual muscle strength testing, pain assessment using the visual analog scale, Knee Injury and Osteoarthritis Outcome Score, and patient report regarding ability to participate in walking and cycling. A plan of care was established to address weakness of the hip, knee, and ankle musculature; inability to walk longer than 20 minutes; squat; negotiate stairs without use of a handrail; and participate in cycling at higher intensities for longer than 15 minutes. The main goals for the patient were to reduce pain when squatting, negotiate stairs, go on weekly 60 minute walks with her family, and cycle 3 times weekly for 45 minute sessions with higher intensity bouts. Main interventions used were therapeutic exercise with progressive overload, neuromuscular re-education, and task-specific training. The patient achieved the following goals: decreased pain with squatting; decreased pain and assistance with stair negotiation; improved lower extremity strength, motor control, and participation in walking and cycling. The patient was discharged to home with a home exercise program.