Abstract
A 34-year-old female patient, 3 weeks post 3-level cervical disc arthroplasty to treat cervical radiculopathy and myelopathy, was seen for student physical therapy treatment for 7 sessions in a 6-week period at an outpatient orthopedic setting under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with the Neck Disability Index, Numeric Pain Rating Scale, cervical goniometry, and Deep Cervical Flexor test. A diagnostic test cluster was used to help rule out persistent cervical radiculopathy. Response to physical therapy treatment was estimated using a clinical prediction rule. A plan of care was established to address active range of motion loss, increase muscle endurance of the cervicothoracic region, improve sleep, and return the patient to her prior level of function. Main goals for the patient were to reduce cervical pain, restore cervical range of motion, decrease symptoms of paresthesia and dysesthesia, and improve sleep. She wished to return to her prior level of participation as a mother and homemaker and to her recreational activities. Main interventions used were targeted restorative and functional training, patient education, neural desensitization, and manual therapy. The patient responded well and showed improvements to disability scores, active range of motion, cervical motor control, paresthesia, and dysesthesia, and improved her sleep. By 6 weeks, the patient was able to engage with her children and began to return to her recreational interests. The patient continued with their episode of care under the care of the supervising physical therapist with expected discharge at 12-weeks.