Date of Award

2016

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Peggy Mohr

Keywords

Arthritis, Juvenile; Arthroplasty, Replacement, Hip -- rehabilitation; Case Reports

Abstract

Background and Purpose- Juvenile Rheumatoid Arthritis (JRA) is an autoimmune disorder present in children under the age of 17, most commonly seen in females. In JRA, the immune system attacks the body's cells and tissues causing persistent joint swelling and stiffness. There are 3 principle types of JRA, systemic JRA, pauciarticular JRA and polyarticular JRA. Polyarticular JRA is classified as involving 5 or more large and small joints of the legs, arms, jaw and neck. The purpose of this case study was to illustrate the rehabilitation program used for a patient with JRA following a left total hip arthroplasty (THA) in an acute care setting.

Case Description- The patient was a 29 year old female with a diagnosis of Polyarticular JRA. This patient received physical therapy (PT) in the acute care setting following a minimally invasive THA using a posterior approach. This was the patient's 7th total joint replacement surgery.

Intervention- Standard total hip arthroplasty post-operative protocol was implemented following her surgery. Interventions included gait training, bed mobility, transfer training, stair training, patient education and therapeutic exercise.

Outcomes- The patient was able to meet all physical therapy goals and was able to ambulate without an assistive device. She was deemed safe and able to return to home following 3 days in the hospital.

Discussion- Clinical decisions were made to accommodate for the patient's personal motivating forces as well as the patient's lack of financial resources. Investigation of preventative physical therapy versus surgical joint replacement for patients with JRA was recommended.

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