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Outpatient physical therapy for a patient with chronic bilateral lower extremity injury due to a generalized tonic-clonic seizure
A 34-year-old male patient 10 months status post generalized tonic-clonic seizure and consequent bilateral Achilles tendon and triceps surae injury was seen for six physical therapy treatment sessions over eight weeks at an outpatient pro bono 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 with active and passive ankle range of motion, the Thompson test, unilateral heel raise, the Foot and Ankle Ability Measure, the Lower Extremity Functional Scale, the Fear-Avoidance Beliefs Questionnaire, and the Numeric Pain Rating Scale. Subsequently, a plan of care was established. Main goals for the patient were to improve range of motion, strength, fear- avoidant behaviors, and to help the patient return to participation in high intensity v recreational activities. Main interventions used were soft tissue mobilization and stretching, ankle mobilization, strength training, patient education, and gait training. The patient experienced improvements in pain, functional ankle range of motion, strength, fear-avoidant behaviors, and walking gait performance. The patient was discharged home with a progressive home exercise program.