The Pulse

Resolving Fall-Related Trauma Pain and Improving Mobility with Biophysical Agents and Exercise

Posted by ACP on Mar 5, 2019 4:05:11 PM

Patient Information: Male, Age 66

Diagnosis: Fall-Related Trauma / Multiple Fractures

History: This gentleman was admitted to a skilled nursing facility for rehabilitation services after being hospitalized for two and a half months due to a fall at home while climbing a ladder, resulting in multiple fractures to the left side of his body. While in the hospital he suffered respiratory failure due to a pneumothorax (collapsed lung). Prior to his fall he was living at home, independent with all activities, and worked full-time in the field of construction.

Pre-Therapy Status:
•Pain: Moderate in the shoulders, elbows, hands, and low back.
•Functional Mobility: Moderate (50%) assistance for bed mobility; maximal (>75%) assistance
for transfers.
•Self-Feeding: Dependent (100% assistance).
•Balance: Scored 3/28 on the Tinetti Balance and Gait Assessment, indicating severely
impaired dynamic balance and a high risk of falling.
•Gait: 5 feet with a front wheeled walker and maximal (>75%) assistance; unable to climb stairs.

Therapy Information:
•Modality: OmniStim® FX2 Pro Patterned Electrical Neuromuscular Stimulation (PENS),
Megapulse® II Shortwave Diathermy, OmniSound® 3000 Pro Therapeutic Ultrasound System,
OmniCycle® Elite Motorized Therapeutic Exercise System.
•Frequency: 5x per week.
•Protocol Specifics: Upper extremity triphasic PENS to the left wrist flexors/extensors
and lower extremity triphasic PENS to the quadriceps/hamstrings to improve coordination
and strength. Alternated thermal diathermy and ultrasound to the low back, shoulders
and hands to decrease pain. OmniCycle® upper and lower extremity neuro mode to improve
arm and leg strength.
•Duration: Fourteen weeks.
•Other Therapy Services Provided: Gait training, manual therapy, therapeutic exercise,
wheelchair management, neuromuscular re-education, and activities of daily living training.

Outcome:
•Pain: Pain-free in the shoulders, elbows, hands, and low back.
•Functional Mobility: Independent for bed mobility and transfers.
•Self-Feeding: Independent.
•Balance: Scored 20/28 on the Tinetti Balance and Gait Assessment, indicating markedly
improved dynamic standing balance and lowered (moderate) risk of falling.
•Gait: 225 feet with a front wheeled walker and supervision; able to climb four stairs with verbal
reminders for safety.

This gentleman and family are so excited about his progress in therapy and ability to return home!

Topics: Patient Success Story, Fall Prevention & Balance, Pain Management

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