Non-surgical Knee Osteoarthritis Treatment

Case Study: Non-surgical Knee Osteoarthritis Treatment

Richard J. Vicory, PT

Introduction

Patient is an 85 year old male with history of heart attack and bilateral femoral popliteal bypass graft. Patient reports difficulty walking and standing greater than 10 min., and difficulty stepping up/down curb secondary to weakness. Patient ambulates with moderate antalgic gait. Pain is 7/10, bilateral lower extremity strength is grossly 3/5, and knee AROM is Right 0-101 degrees and Left 0-99 degrees.  Patient scores 35/56 on the Berg Balance Scale, indicating a high risk for falls. Patient is not a candidate for total knee replacement due to bilateral femoral popliteal bypass graft. Patient needed non-surgical knee osteoarthritis treatment.

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Goals

  • Increase lower extremity strength and ROM to facilitate normal gait pattern
  • Improve dynamic balance to facilitate walking on even and uneven terrain for increased patient safety
  • Safely step up/down 8 inch curb without rail to facilitate crossing street

History / Progression

Weeks 1-2: Stretching hamstring and achilles, recumbent bike 15 minutes and physical therapy exercise on the AlterG Anti-Gravity Treadmill.

Week 3: Stretching hamstring and achilles, recumbent bike 20 minutes and AlterG Anti-Gravity Treadmill.

Week 4: Stretching hamstring and achilles, recumbent bike 20 minutes and AlterG Anti-Gravity Treadmill.

Week 5: Stretching hamstring and achilles, recumbent bike 20 minutes and AlterG Anti-Gravity Treadmill.

Week 6: Stretching hamstring and achilles, recumbent bike 20 minutes and AlterG Anti-Gravity Treadmill.

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Results

Patient was very motivated and enjoyed his physical therapy sessions. Patient reported significant improvement of knee pain with prolonged activities. All goals were met and at discharge patient reported that knee pain decreased to 2/10, knee AROM improved on Right 0-112 degrees and Left 0-106 degrees. Bilateral lower extremity strength improved to 4/5, and Berg Balance Scale improved to 43/56, lowering risk for falls. Patient also reported at discharge that he notices functional improvement in getting in/out of car, walking in yard, and stepping up/down curb.

The physical therapy equipment used was the AlterG Anti-Gravity Treadmill which was incorporated into this patient’s treatment plan to reduce patient’s pain during ambulation.  Reducing the patient’s body weight allowed the patient to perform functional activities and gait training with decreased joint compression, helping to reduce pain during gait. By slowly reincorporating the patient’s body weight, we were able to see significant pain reduction and marked improvements in ROM,strength, and balance.

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