Abstract
A 72-year old woman status post left supraspinatus repair, with distal clavicle resection, acromioplasty, and osteophyte removal, was seen in outpatient physical therapy for an 8-week episode of care. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The initial examination was conducted at week 3 post-surgery. She was evaluated with manual muscle testing, range of motion assessment, Numeric Pain Rating Scale, the Quick Disabilities of Arm, Shoulder, and Hand Questionnaire, the Shoulder Pain and Disability Index, the Patient Specific Functional Scale, and the Global Rating of Change Scale. The patient presented with shoulder pain, decreased range of motion and strength, and difficulty with upper body dressing, cooking, and bathing. The patient’s main goals included improving shoulder active range of motion and strength, quality of sleep, and her ability to dress, bathe, and cook. Physical therapy treatments were administered twice weekly for 8 weeks, and her plan of care followed post-operative rotator cuff repair protocols. Treatments consisted of passive range of motion, scapular and accessory joint mobilizations, soft tissue massage, and postural education. Gradual strengthening was introduced as tissue healing improved. A home exercise program was implemented, which she adhered to. At week 8, the patient had improvements in shoulder active range of motion, quality of sleep, and ability to use her arm for dressing, cooking, and bathing. However, 8 weeks was not sufficient for the patient to reach functional goals, and the student therapist’s last week was during the patient’s 8th week of care. Thus, the student therapist planned for the patient to continue physical therapy for 6 more weeks after the student’s clinical rotation.