Patient Information: Male, Age 69

Diagnosis: Chronic Heart Failure / Muscle Weakness / Kidney Failure

History: This man was admitted to a skilled nursing facility after a seven day hospital stay due to a decline in his ability to care for himself and his wife. He was referred to occupational and physical therapy to improve his strength and function, with the goal to return home and resume his role as the primary caregiver for his wife.

Pre-Therapy Status:

• Strength: Poor to fair (2 – 3/5) in both arms; poor (2/5) throughout both legs.
• Pain: Moderate (7/10) in both knees; pain inhibits most functional activities.
• Self-care: Maximal (75%) assistance with dressing, bathing, and toileting; minimal (25%)
  assistance for feeding.
• Functional Mobility: Moderate to maximal (50 – 75%) assistance with bed mobility; maximal (75%) assistance with transfers.
• Ambulation: Unable to walk. Uses a wheelchair for mobility and requires maximal (75%)
  assistance to advance 25 feet.

Therapy Information:

• Modality: OmniCycle^® Elite Motorized Therapeutic Exercise System, Shortwave Diathermy,
  and Patterned Electrical Neuromuscular Stimulation (PENS).
• Frequency: 5x per week.
• Protocol: Subthermal shortwave diathermy to both knees for pain; triphasic PENS to upper
  and lower extremities to improve strength and neuromuscular coordination. OmniCycle^® neuro mode to improve strength and aerobic capacity.
• Duration: Ten weeks.
• Other Therapy Services Provided: Therapeutic exercise, therapeutic activity, neuromuscular
  re-education, gait training, ADL retraining, and static/dynamic standing balance activities.

Outcome:

• Strength: Good (4/5) throughout both arms and legs.
• Pain: Absent (0/10) in both knees.
• Self-care: Minimal (25%) assistance for bathing and dressing; independent for eating; supervision for toileting due to safety.
• Functional Mobility: Independent with bed mobility; supervision with transfers.
• Ambulation: 250 feet with a wheeled walker and guiding contact from the therapist for steadying assistance; able to independently ascend/descend ten steps with the use of a handrail.

This man is very pleased to be able to return home and help take care of his wife! Since returning home, he has received eight weeks of home health therapy services and has achieved his prior level of function. He is now independent within the home and community for all mobility and self-care.