Outpatient physical therapy for a patient with lumbosacral transitional vertebrae and chronic low back pain

A 73-year-old male with chronic low back pain and a diagnosis of lumbosacral transitional vertebrae was seen once a week for twelve weeks at an outpatient physical therapy clinic. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The patient was evaluated with goniometry, the passive knee extension test, manual muscle testing, the numerical pain rating scale, the straight leg raise test, the crossed straight leg raise test, the Oswestry Disability Index, and the Fear-Avoidance Beliefs Questionnaire. A plan of care was established with the main goals of increasing range of motion, strength, functional ability, and sleep quality, as well as for the patient to return to golf, and to reduce pain and fear-avoidance beliefs. Interventions included directional preference and therapeutic exercises, manual therapy, motor control training, a home exercise program, and patient education. The patient increased range of motion, strength, functional ability, and sleep quality, was able to play golf with limitations, and reported a decrease in pain. He was discharged home with a home exercise program that included information on continuing his graded return to golf.