Abstract
A 71-year-old patient 6 weeks post-operative for open reduction internal fixation of a distal radius fracture was seen for physical therapy treatment for 12 sessions in a 6 week period in an outpatient setting. The treatment was provided by a student physical therapist under the supervision of a licensed physical therapist.
The patient was examined at the initial encounter with Visual Analogue Scale, short arm goniometry, manual muscle tests, handheld dynamometer, Disabilities of Arm, Shoulder and Hand questionnaire, Patient Rated Wrist Evaluation, and the Patient Specific Functional Scale and a plan of care was established to address moderate to severely limited wrist range of motion, decreased grip strength, and high levels of pain leading to severely limited right upper extremity function. Main goals for the patient were able to do house and yardwork without pain. Main interventions used were therapeutic exercise, manual therapy and modalities implementing a bottom-up approach. The patient achieved the following goals: clinically significant reduction in activity-related pain and improvements in ROM and UE function. The patient was transferred to another physical therapist to continue her improvements in mobility, strength and functional outcomes, due to the student’s clinical rotation ending.