Date of Award


Document Type


First Advisor

Mark Romanick


total knee arthroplasty, knee pain, knee range of motion, gait training, manual therapy, aquatic therapy, neuromuscular reeducation, quality of life


Background and Purpose. Knee osteoarthritis is an increasingly prevalent diagnosis in the aging population and total knee arthroplasty is one of the most common treatment options in the advanced stages. The purpose of this article is to describe the interventions and results with an outpatient physical therapy program based on mobility and gait training.

Case Description. This case study focuses on the intervention and management of a total knee arthroplasty in a 78-year-old female over 8 weeks. She had a typical presentation of restricted range of motion, gait and proprioception deficits, and lower extremity weakness of the surgical limb.

Interventions. The treatments were based off patient's limitations in range of motion, strength, abnormal gait patterns, and proprioception deficits. Interventions included balance training, gait training, manual therapy, and therapeutic exercises and activities. A large focus on this program was gait training drills to normalize gait pattern to return to prior level of function. Aquatic therapy was also utilized in this plan of care for a long-term exercise regime.

Outcomes. Following physical therapy intervention, the patient was able to normalize her gait pattern without the use of an assistive device, restore range of motion, and make functional strength gains to aid with independent ADL 's. She was also able to establish an independent aquatic-based exercise routine.

Discussion. All exercises were progressed as tolerated and in accordance with post-surgical protocol with success. Gait training, exercise, and aquatic therapy could have all been factors contributing to her final functional level. Following physical therapy care episodes, the patient was able to return to prior level of function and increase overall quality of life.