Physical Therapy Interventions and Outcomes for a Patient with Multiple Co-Morbidities: A Case Study
Date of Award
5-2024
Document Type
Scholarly Project
Degree Name
Doctor of Physical Therapy (DPT)
Department
Physical Therapy
First Advisor
Steven Halcrow
Keywords
Co-morbidities, inpatient mortality rates, individualized training, multimorbidity, multiple chronic conditions
Abstract
Introduction. Multimorbidity is present in a significant percentage of hospital admissions with 84.1% involving one or more co-morbidities leading to longer, more expensive stays and higher inpatient mortality rates. The purpose of this case study is to evaluate physical therapy’s effects, interventions and outcomes for a patient with common co-morbidities to determine physical therapy outcomes.
Case Description. The patient was a 75-year-old female who presented to physical therapy with an admitting diagnoses of congestive heart failure and acute kidney injury. Her additional relevant medical diagnoses were hypertension, diabetes mellitus type 2, obesity, depression, 2-month status post ORIF of right ankle fracture, GERD, acute gastrointestinal distress and multiple lower extremity ulcers. Upon examination and evaluation, the patient was given the physical therapy diagnoses of generalized weakness, reduced mobility, unsteadiness on feet, difficulty walking and fatigue.
Intervention. The patient was seen four days a week for two weeks for 10 to 25 minute sessions. Interventions included transfer training, gait training, endurance training, balance training, seated exercises and education.
Outcomes. Over the course of treatment, the patient decreased the level of assistance required for transfers and increased her ambulation distance which allowed her to discharge to a skilled nursing facility. Overall, she improved her tolerance to activity, endurance and gait pattern.
Discussion. The presence of multiple co-morbidities complicates physical therapy treatment sessions, but modifications to therapy leads to improvements in impairments. Each co-morbidity requires awareness in order to treat, and each impacts therapy in a different way. Multimorbidity also impacts a patient’s chances of re-admission to the hospital, so therapy should recognize the importance of individualized training to address functional limitations
Recommended Citation
Johnson, Morgan M., "Physical Therapy Interventions and Outcomes for a Patient with Multiple Co-Morbidities: A Case Study" (2024). Physical Therapy Scholarly Projects. 793.
https://commons.und.edu/pt-grad/793