Abstract
A 35-year-old male patient 2 weeks status-post right anterior cruciate ligament reconstruction with a hamstring allograft and partial medial meniscectomy was seen for 12 sessions over the course of 6 weeks at an outpatient physical therapy clinic. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with goniometry, manual muscle tests, girth measurements, the numeric pain rating scale, the Wells criteria, observation of gait, the lower extremity functional scale, the patient specific functional scale, and patient report. A plan of care was established to address decreased knee range of motion and muscle strength, decreased right lower extremity muscle endurance and neuromuscular control, knee joint effusion, pain, gait deviations, inability to squat, and impaired lower extremity function. Main goals for the patient were to improve range of motion and strength, decrease pain and swelling, return to normal gait, improve squat ability, improve lower extremity function, and return to hiking and strength training his lower extremities for recreation. Main interventions used were manual therapies, therapeutic exercises, gait training, neuromuscular re-education, neuromuscular electrical stimulation, patient education, and intermittent pneumatic compression with circumferential cryotherapy. The patient achieved the following goals: increased range of motion and muscle strength, decreased pain and swelling, return to normal gait, ability to partially squat, and improved lower extremity function. The patient was transferred to continued care with a physical therapist to continue physical therapy and return to his prior level of function.