Patient Information: Female, Age 68

Diagnosis: Respiratory Failure

History: This woman was referred to a skilled nursing facility due to severe deconditioning following a two-month hospitalization for pneumonia, during which she experienced respiratory arrest and required ventilation by tracheostomy intubation (surgical procedure inserting a breathing tube through the trachea to restore breathing).

Pre-Therapy Status:

• Leg strength: Poor (2/5) throughout both legs.
• Bed Mobility: Maximal (75%) assistance.
• Transfers: Dependent (100% assistance); required mechanical lift (Hoyer device) from bed to wheelchair.
• Ambulation: Unable to stand and walk.

Therapy Information:

• Modality: Patterned Electrical Neuromuscular Stimulation (PENS).
• Frequency: 3x per week.
• Protocol: Lower extremity triphasic PENS, alternating between knee and ankle protocols to increase strength.
• Duration: Six weeks.
• Other Therapy Services Provided: Therapeutic exercise for strengthening, transfer training, activity of daily living (ADL) retraining, and gait training in parallel bars.

Outcome:

• Leg Strength: Good minus (4-/5) throughout both legs.
• Bed Mobility: Independent.
• Transfers: Independent with supervision.
• Ambulation: 50 feet using a rolling walker with guiding contact (10%) by the therapist for steadying assistance.

This woman and her family are amazed with the progress she made in therapy! Due to the combination of her determination, skilled therapy interventions, and PENS use for leg strengthening, she has returned home with her husband and has achieved her personal goal of attending her grandson’s graduation ceremony.