Abstract
A 67-year-old female patient with a right primary total knee arthroplasty was seen by a student physical therapist for 10 sessions over 5 weeks in an outpatient physical therapy facility under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with Wells criteria, girth measurements, Numeric Pain Rating scale, goniometry, manual muscle tests, Lower Extremity Functional Scale, walking evaluation, Timed Up and Go, and 5x Sit to Stand. A plan of care was established to address the impairments of edema of surgical knee, decreased right knee range of motion in flexion and extension and decreased strength of right knee and bilateral hip musculature. Impairments contributed to activity limitations such as: decreased balance, decreased lower extremity strength, decreased standing tolerance, and inability to drive, climb stairs, and ambulate for household or prolonged distances. These activity limitations restricted the patient’s participation at work as a branch manager for a tax preparation company. Main goals for the patient were to decrease post-operative swelling and pain, improve knee range of motion, strength, and functional tasks performance, such as walking and performing transfers. Main interventions used were range of motion exercises, strength training, over-ground walking training, functional task training, neuro-muscular electrical stimulation (NMES), and cold compression. The patient demonstrated improvements in strength, range of motion, walking outcomes, and reported function. The patient was discharged to live at home and continue care under the supervising licensed physical therapist to continue her outpatient physical therapy.