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Multimodal physical therapy for a patient with hip osteoarthritis
A female patient with right symptomatic hip osteoarthritis (OA) was seen for physical therapy (PT) treatment during 10 visits at a university pro bono outpatient PT clinic. The examination and treatment were provided by a student physical therapist under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with the Six-Minute Walk Test, Five-Times Sit-to-Stand Test, Nine-Step Stair Climbing Test, Western Ontario and McMaster Universities Osteoarthritis Index, as well as handheld dynamometry, goniometric measurements, the Numeric Pain Rating Scale, and American College of Rheumatology Criteria. An initial five-week plan of care was established. Main goals for the patient were to increase right hip strength and range of motion (ROM), to improve functional mobility and walking ability by reducing pain, to decrease disability due to hip OA, and to increase her ability to participate in recreational physical activities. Main interventions used were orthopedic manual therapy, bodyweight supported treadmill training, and therapeutic exercise with a corresponding home exercise program. The patient experienced a reduction in pain with activities; improved ROM, functional mobility, and walking ability; improved participation in recreational physical activities; and experienced a reduction in disability due to hip OA. The patient was discharged from PT with an individualized home exercise program to continue living at home.