Abstract
A 70-year-old female patient status post right total knee arthroplasty following medical diagnosis of right knee osteoarthritis was seen for student physical therapy treatment for 16 sessions over 8 weeks in an outpatient orthopedic physical therapy clinic under the supervision of a licensed physical therapist.
The patient was examined at the initial encounter with manual muscle testing, goniometry, girth circumference measurements, numeric pain rating scale, 30-second sit-to-stand test, 6-minute walk test, the Western Ontario and McMasters Universities Arthritis Index, the Wells’ Criteria, timed up and go test, and patient report of activity and participation restrictions. A plan of care was established to address impairments in range of motion and strength, limitations in activities of daily living, balance, functional mobility, and restrictions with paddleboarding with friends and work-related duties as a dog walker. The main goals for the patient were increased right knee flexion range of motion and strength, improved functional mobility and independence with ambulation, improved dynamic balance and reduction in risk for falls, and return to participation in work-related duties and paddleboarding. The main interventions used were an impairment-based approach using task-specific training along with patient education. The patient achieved the following goals: improvements in knee strength, dynamic balance, independence with gait, functional mobility, and the ability to participate in work-related duties and paddleboarding. The patient was discharged from outpatient physical therapy with an independent home exercise program.