Physical Therapy Osteoarthritis Intervention

A CASE STUDY:
PHYSICAL THERAPY INTERVENTIONS IN A PATIENT WITH KNEE
OSTEOARTHRITIS.
ABSTRACT :
BACKGROUND AND PURPOSES: Osteoarthritis is a common chronic and
progressive musculoskeletal condition that starts from middle age onwards.
In this condition, degeneration of joint cartilage and the underlying bone
occurs. OA or Osteoarthritis is a situation, where due to degradation of
cartilage and due to increase friction of bone joint, the patients suffer from
knee pain, blockage, stiffness and other issues. It restricts patient’s body
movement and regular functionality. In this following section the risk factors
associated with Osteoarthritis for 60 years old patient have been discussed
including occupational overuse of the knee. Conservative treatment involves
lifestyle modification, education, strengthening exercises prescriptions, and
weight reduction1.
CASE DESCRIPTION: The patient was a 60 years old obese male who had
moderate pain increased with activity such as walking, going up and down
on stairs, difficulty to stand for a long period of time at work. Physical
therapy interventions including strengthening exercises, endurance training,
lifestyle modifications, and Interferential current were provided to this
patient with follow up visits.

OUTCOMES: Physical therapy sessions were provided 3x/week for 5 weeks.
After these sessions, the patient will be presented with increased muscle
strength and reduced level of pain. Additionally, the patient had reduced his
body weight by changing his lifestyle.
DISCUSSION: This report is based on the assessment of the physical
therapy interventions for improved functional outcome in an overweight
patient who was reported to have knee OA. This case report reviews physical
therapy interventions including patient education, lifestyle modifications, and
therapeutic exercises and endurance training. These interventions are very
beneficial for effective management of patients with knee Osteoarthritis
related pain to improve their functional improvement associated with range
of motion, level of muscle strength endurance, movement coordination along
with other related factors.
BACKGROUND AND PURPOSE:
Osteoarthritis (OA) is a very common progressive joint disease caused by
cartilage degeneration. It is also known as degenerative arthritis. OA can
affect any joint of the body, but it occurs most often in knees, hips, lower
back, neck, and small joints of the fingers. In osteoarthritis, the cartilage
between the bone-joint degrades and gradually become reduced in volume
significantly. Because of the lack of surface area coverage of cartilage
between two joining bones the protective space decreases. Lack of
protective space increases friction in the bone joint significantly, which

develops the bone spurs. Bone sparse creates an additional blockage, mainly
in extension and flexion movement of the joint1. Due to this anatomical
condition 7 types of symptoms can be found in patients namely pain, joint
stiffness, tenderness, loss of flexibility, elevated sensation, swelling of the
area a lump structured bone spurs. The degradation of the cartilage can
occur as a result of high pressure on joint due to overweight of the body,
structural weakening due to age, and repeated stress on the joint. Certain
metabolic diseases and bone deformities can also cause OA.
Knee osteoarthritis (OA) is a significant common medical problem since it
causes chronic pain, decreases and limits the physical capacity and affects
the quality of life. Physiotherapy increases the joint movement that helps to
prevent the growth of spurs. Water based physiotherapy allows to reduce the
strength on joint and to increase the strength of associated muscles. Physical
movement allows reduction of fatigue to have a healthy body weight that
can reduce the pressure on a particular joint. Additionally, aging and
overweight increase the prevalence of knee OA significantly. However,
physical therapy interventions are very helpful to address knee OA1. Physical
therapy interventions are considered a conservative treatment for knee OA.
Which includes different types of strengthening exercises include active
assisted, active and progressive resistive exercises. The prescription of the
exercises generally includes a description of frequency, duration, and
intensity, endurance training, electrical modalities, and lifestyle modification.

The goal of this case report is to explain how physical therapy interventions
can help patients with knee osteoarthritis to increase range of motion of all
impaired joint planes, to increase strength all impaired muscle groups,
maximize gait quality and quantity, use appropriate assistive devices,
Improved balance proprioception and Independence with the home exercise
program.
CASE DESCRIPTION: The patient is 60 years old male who has moderate
pain in his knees for the last 6 months. The chief complaint of this patient
was limited walking, difficulty to ascend/ descend stairs, pain, swelling and
morning stiffness. Past medical history includes gout, vascular necrosis, DM
type 2 and morbid obesity.
Patient-reported taking no medication and he was independent in functional
life. Pt lived alone in an apartment on the second floor and has 8 stairs. The
Patient worked as a cashier in a clothing store, where he had to stand for
prolong time. Prior level of function included ambulation without an assistive
device for unlimited distance and ability to ascend and descend stairs
without pain. The patient's goal is to return to a prior level of function.
CLINICAL IMPRESSION: This patient's detail was helpful to perform a
physical examination. The reason for the examination was to assess
functional limitations, structural impairments, and activity limitations. The
Patient is a good candidate for physical therapy because of his high prior
level of function, patients’ determination to achieve his functional goals.