Patient Information: Male, Age 73

Diagnosis: Chronic Obstructive Pulmonary Disease (COPD) exacerbation

History: This gentleman was referred to a skilled nursing facility for rehabilitation services to address significant weakness and functional decline after an exacerbation of  COPD.

Pre-Therapy Status:
• Breathing: 6-8 liters of supplemental oxygen with significant shortness of breath for all activities.
• Bed mobility: Dependent (100 % assistance) to get in/out of bed.
• Gait: Unable to stand and walk.
• Activities of Daily Living (ADL): Dependent (100% assistance) for grooming, upper
body dressing, and feeding.

Therapy Information:
• Modality: Patterned Electrical Neuromuscular Stimulation (PENS).
• Frequency: 3-5x per week.
• Protocol: Upper extremity triphasic ADL and shoulder protocols and lower extremity triphasic knee protocols to increase coordination and strength.
• Duration: Eight weeks.
• Other Therapy Services Provided: Energy conservation techniques, therapeutic
exercises, caregiver education, gait training, and balance training.

Outcome:
• Breathing: 5 liters with minimal shortness of breath for all activities.
• Bed mobility: Independent getting in/out of bed.
• Gait: 100 feet with close supervision of therapist using a rolling walker.
• Activities of Daily Living: Independent for grooming, upper
body dressing, and feeding.

The therapy manager reported this gentleman was scheduled to use hospice services due to his poor medical condition and functional status related to his diagnosis of COPD. It was a challenge for him to perform any activity, and the addition of PENS was an integral part of his recovery. Due to the significant improvements in his mobility during the course of therapy, he has returned home with his wife!

His therapist stated: "his spirits were so high by the end of therapy that he was joking with the staff... it was an amazing recovery!"