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Outpatient physical therapy for a patient with cervical and thoracic pain
A patient with cervical and thoracic pain was seen for student physical therapy treatment for 6 visits from 3/12/14 to 4/30/14 at an outpatient clinic under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with range of motion (ROM), cervical flexion endurance test, Kibler scapular retraction test, side plank endurance test, Beiring Sorensen test, and the Neck Disability Index, and a plan of care was established. Main goals for the patient were to restore thoracic ROM to within normal limits (WNLs), improve muscular endurance and strength of the core, spine extensors, scapula depressors, and retractors, improve ability to perform student responsibilities (computer work, carrying a backpack, sitting at desk for prolonged periods) without complaints of pain, return to archery, playing guitar, and workout program. Main interventions used were task-specific strength and endurance training, manual therapy, ergonomic training, home exercises program, and patient education. The patient achieved the following goals: thoracic ROM increased to WNLs, reached normal limits on all endurance outcome measures, achieved unrestricted sitting endurance, achieved unrestricted lifting/carrying loads, and the patient was able to return to archery and guitar participation. The patient was discharged to his current residence with an independent self-management program incorporating gym-based training, a graduated rehabilitation program, and a return to sport outline.