Abstract
A 65-year-old female 4-weeks status post left knee partial medial meniscectomy and debridement was seen for physical therapy for 9 visits over 8-weeks at an outpatient clinic. She had a significant number of comorbidities, including knee osteoarthritis, hypothyroidism, tachycardia, hypertension, dyslipidemia, chronic migraines, and polypharmacy. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The patient was evaluated with girth measurement, goniometry, manual muscle testing, numeric pain rating scale, knee injury and osteoarthritis outcome scale, 10-meter walk test, 5-times sit to stand, timed up and go, global rating of change scale, Wells’ critieria for deep vein thrombosis, and a constellation of fall risk indicators. A plan of care was established to address her knee pain, reliance on ambulatory assistive devices, decreased knee range of motion, lower extremity weakness, limited walking speed, and significant fall risk. Her goals were to decrease knee pain, ride a stationary bicycle for 30-minutes, walk for 30 minutes without an assistive device, grocery shop without using a cart for support, and use narcotics less frequently. Main interventions used were manual therapy, modalities, knee range of motion, stretching, resistance and aerobic exercise. The patient had a fair prognosis for short term recovery, low risk for deep vein thrombosis, and significant fall risk. She met or had significant improvements in most of her goals. The patient was transferred to the care of a licensed physical therapist to continue treatment to improve left knee pain, range of motion, and bilateral hip strength.