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KMID : 1101520180220010039
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Journal of Korean Society for Neurotherapy
2018 Volume.22 No. 1 p.39 ~ p.46
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A Progressive Physical Therapy Plan of Care for a Patient with Bilateral Knee Pain due to Degenerative Joint Disease following a Cerebral Vascular Accident: A Case Report
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Godoy JC Trejo
Ko Man-Soo
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Abstract
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Purpose: The purpose of this case report was to describe the effects of a 6-week physical therapy program consisting of strengthening exercises, balance training, stretching and self- managing education of an adult with bilateral knee osteoarthritis (OA) and cerebral vascular accident (CVA) during an outpatient episode of care.
Methods: The individual was a 62-year-old female with a history of bilateral knee osteoarthritis and recent history of mild CVA. The subject participated in a 6-week physical therapy program consisting of strengthening exercises, balance training, stretching and self- managing education. The subject was seen 3 times a week, with a day of recovery between each therapy session. The Lower Extremity Functional Scale (LEFS), Berg Balance Scale (BBS), Manual Muscle Test (MMT), Time Up and Go (TUG), Numeric Pain Rating Scale (NPRS), 10-Meter Walk Test (10MWT) and Five Time Sit to Stand Test (FTSST) were used to assess progress in this subject.
Results: Outcome measures were used at evaluation and were administered every two weeks. The Timed Up and Go improved from 22 seconds to 12 seconds. The Five Time Sit to Stand Test improved from 39 seconds to 16 seconds, while the Berg Balance Scale improved from 43 to 52 points. Lower Extremity Functional Scale improved by 9 points and gait speed improved by 0.27m/s. The Numeric Pain Rating Scale was monitored throughout the course of treatment, which served as a guide that pain was not exacerbated and that the exercise program was well tolerated by the subject.
Conclusion: This case report describes an exercise program that significantly decreasing pain, while improving balance, functional strength, and gait kinematics with no adverse effect in a subject with bilateral knee osteoarthritis with recent mild CVA. We believe that a significant reduction of pain induces a better functional performance in the subject with OA and CVA.
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KEYWORD
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Physical Therapy, Plan of Care, Knee Pain, Degenerative Joint Disease, Cerebral Vascular Accident
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