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A multimodal rehabilitation approach including body weight supported treadmill training, manual therapy, and therapeutic exercise for a patient with hip osteoarthritis
A patient with bilateral (BL) hip osteoarthritis was seen for physical therapy treatment over 6 weeks for 10 sessions 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 at the initial encounter assessing: pain intensity with the Numeric Pain Rating Scale, hip range of motion (ROM) with a standard goniometer, hip isometric strength testing with a hand held dynamometer, gait endurance with the 6 minute walk test, and physical function with the Western Ontario and McMaster Universities Arthritis Index (WOMAC); and a plan of care was established. Main goals for the patient were to decrease BL hip pain, improve hip strength, increase hip ROM, increase gait endurance, and resume all daily life activities without pain. The main interventions used were body-weight supported treadmill training, manual therapy focusing on mobilization techniques, and therapeutic exercises. The patient improved strength in BL hip abduction, improved ROM for left hip internal rotation, and resumed all daily life activities without pain. In addition, the WOMAC score was significantly decreased representing a lower amount of overall disability. The patient was discharged to continue living at home with a progression in home exercise program and recommendations for daily physical activity.