Abstract
A patient status post closed treatment without manipulation of a minimally displaced fracture to the distal left (L) fibula was seen for physical therapy (PT) treatment for 16 sessions over a three-month period at an outpatient PT clinic. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. Upon initial evaluation, the patient, an 83-year-old female who experienced an ankle fracture two-months prior, was to remain weight bearing as tolerated with the L lower extremity in a controlled ankle motion walker boot for six weeks. During her course of treatment, the following measures were assessed: goniometry to assess active range of motion (AROM), manual muscle test to assess strength, Timed Up and Go to assess risk for falls, Lower Extremity Functional Scale to assess activities of daily living, and Berg Balance Scale to assess impaired mobility and balance in standing. Deficits were identified and a plan of care was established. The goals for this patient were to improve AROM, strength, balance, gait, and return to her prior level of function. The patient’s central goal was to prevent future falls. Main interventions used were manual therapy, task-specific therapeutic exercise, proprioception and balance training, warm water aquatic therapy, gait training, and instruction in a home exercise program (HEP). The patient achieved gains in AROM, strength, balance, gait, and functional independence. The patient’s goals to reduce fall risk and return to her prior level of function were met as well. The patient was discharged to home with a HEP.