Abstract
A 74-year-old female patient following right total hip arthroplasty was seen for three physical therapy sessions over a span of two days at an acute care facility. The patient’s past medical history included primary hip osteoarthritis, coronary artery disease, and obesity. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter using the Numeric Pain Rating Scale, Goniometry, Timed Up and Go, 10 Meter Walk Test, Activity Measure for Post-Acute Care “6 Clicks”, and the Wells Criteria for Deep Venous Thrombosis. A plan of care was established to address severe pain levels, moderately impaired right hip abduction and flexion passive range of motion, severely impaired gait speed, severely impaired functional strength, moderately limited functional mobility, and the inability to safely return home with her fiancé. Main goals for the patient were to decrease pain, improve walking ability with an assistive device, negotiate one stair to enter her home, be capable of entering her sports car, and return to cooking independently. Primary interventions used were a combination of therapeutic exercises, task-oriented training, and therapeutic activities.
The patient responded well to the plan of care and demonstrated improvements in gait speed, functional mobility, hip abduction and flexion passive range of motion, and general lower extremity muscular strength. The patient was discharged home to her fiancé with a home exercise program and a referral for home health physical therapy.