Right Total Hip Replacement

During my second clinical experience I had the opportunity to work with a 72 year old female patient that came to the nursing facility for rehab due to right total hip replacement. Upon seeing her the first time she had returned home and she was now coming in for therapy as an outpatient. I continued her standing lower extremity exercises increasing sets, reps and intensity with weights as tolerated. Following precautions of no hip external rotation, extension, or adduction as her surgery was an anterior lateral approach. I progressed her from a 2 wheel walker to a single point cane increasing walking distance. I also used the Sitfit bike to increase exercise tolerance and endurance. Working on balance using a foam mat progressing with narrowing stance, increased reps and hold times, playing catch and decreasing assistance. In the parallel bars I worked on gait drills to improve gait and equal weight distribution. As she got more confident and her strength, balance and endurance improved she was reassessed and discharged.

Left Broken Ankle

During my second clinical experience I had the opportunity to work with a 76 year old female patient that came to the nursing facility for a short term stay for rehab. She had broken her left ankle after a fall at home. Upon seeing her for the first time she was non weight bearing and was wearing a boot. I started with seated lower extremity strengthening. and seated core exercises. Progressing sets and reps and increased indencity with weights and therabands as tolerated. Her doctor had cleared PT to take off her boot to do light non weight bearing exercises for the left ankle. As time progressed and her strength and healing improved her doctor cleared her for weight bearing as tolerated. While she had her boot on and using the parallel bars I worked on her standing tolerance. Progressing reps, hold times and minimizing assistance. When she was cleared to full weight bearing I started gait training with a two wheel walker. Progressing with increased distance, reps, minimizing assistance, decreasing use of assisted device. As she improved and was cleared to discontinue use of her boot. I started gait drills in the parallel bars, obstacle course, progressed seated lower extremities to standing, progressed standing tolerance with foam mat while playing games and increasing walking distance with a single point cane. Preparing her to move to an assisted living facility.

High blood pressure, Heart problems OCD, Overweight

 During my second clinical experience I had the opportunity to work with a 67 year old female who had heart problems, high blood pressure, OCD, and is overweight. I made sure to check her vitals before, during and after treatment to insure her numbers stayed in a safe range. When working with her we worked on seated lower extremity and core strengthening. This was to improve strength to assist her in standing as she was a moderate assist to stand and had low standing tolerance. When working with her OCD many things had to be adjusted before she would be willing to work or it would give her anxiety such as the front wheels of her wheelchair had to be turned and she was only willing to come to therapy at certain times. When I first started working with her it was a slow start as I had to earn her trust as she thought I was too small to help her. She also did not like me holding her gait belt. Many times she would blame my holding her gait belt if she was unable to stand. Throughout the time I progressed her in standing tolerance, walking distance, and exercises by sets, reps, hold time and used weights and therabands. She had shown improvements with walking distance, standing tolerance, strength, and she was able to stand up with min/mod assist. It was then that she had some heart problems and there was concern of a heart attack. Thankfully it ended up not being a heart attack. However she was off of therapy for a few days to recover and this did set her back. When she was cleared to start therapy again she was no longer able to walk or stand. With this I had to regress treatment and work our way back up.

Group therapy

During my second clinical I gained the experience of planning and performing group therapy sessions ranging from 2 to 4 patients at a time doing similar exercises I would rotate as help, corrections or changes were needed.

Co-treatment

During my second clinical I gained the experience of performing co-treatments with speech or OT therapy. This is where I would treat a patient at the same time as speech or OT. For example with one patient I was working on standing balance and posture while OT was working on coordination and upper extremity strength.

Consecutive treatment

During my second clinical I gained the experience of performing a consecutive treatment. This is where I would overlap treatments, finishing treating one patient and as I started the next patient. For example I would finish up treatment on one patient on the Sitfit bike as I started exercises with the next patient.