The Pulse

Patient Information: Male, Age 50

Diagnosis: Below Knee Amputation

History: This gentleman was referred to a skilled nursing facility for physical and occupational therapy services after hospitalization due to a non-healing diabetic ulcer on the right foot resulting in a below the knee amputation. Prior to the amputation, he lived at home and was independent with walking and driving.

Acupuncture has been used in traditional Chinese medicine for thousands of years. Over the past few decades, the practice of acupuncture has been accepted in the United States for the treatment of various conditions, including pain management. Traditional acupuncture treatment involves inserting needles at various well-defined points known as “acupoints”. In contrast to needles, research demonstrates that the stimulation of acupoints with transcutaneous electrical nerve stimulation (TENS) and therapeutic ultrasound also reduces pain^{1, 2}.  

The primary function of the hip is to support the weight of the body in both static standing and dynamic activities such as walking, stair climbing, running and sports. Hip weakness can decrease mobility, stability, and increase risk of injury. The external or lateral rotators are a group of six small deep hip muscles which arise from the sacrum & pelvis and insert on or about the greater trochanter, where they act to externally rotate the femur in the hip joint adding stability during functional mobility.

Patient Information: Female, Age 78

Diagnosis: Stroke / Oropharyngeal Dysphagia

History: This woman with a history of several strokes had a subsequent stroke that resulted in severe oropharyngeal dysphagia (difficulty swallowing). She had weakness in her lips, tongue, and muscles involved in her swallow, and required a feeding tube for all nutrition and hydration. She was admitted to a skilled nursing facility after discharge from the hospital. Prior to her most recent stroke she ate a normal diet with thin liquids.

Patient Information: Female, Age 85

Diagnosis: Falls / Back Pain

History: This woman, a long-term skilled nursing facility resident, was referred to therapy by the
nursing staff due to a recent fall in her room, decreased safety awareness, unsafe transfers,
and increased pain in her back and legs. Prior to the fall this woman required supervision to safely get in and out of bed and maximal assistance to walk.