Impact of Physical Therapy on Deconditioning and Functional Decline Following an Acute Hospital Stay Due to Cellulitis and Sepsis: A Retrospective Case Study

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Radencic, Matthew; O'Shea, Robbie; Bala, Amy
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Background and Purpose: Cellulitis associated with sepsis is a common cause for an acute hospital stay, which may lead to deconditioning and loss of function. The purpose of this case report is to contribute to the knowledge base regarding the impact that physical therapy can have on restoring function of a geriatric patient through a reconditioning program in the first month following a prolonged hospital stay due to cellulitis and sepsis. Case Description: Patient was a 77 year- old male who presented to a skilled nursing facility with deconditioning and functional decline following a 15-day acute hospital stay secondary to cellulitis of bilateral (B) lower extremities (LE) and sepsis. The patient had generalized LE weakness, intense LE ankle and knee pain, swelling/edema in B ankles and feet, and dependence on others for activities of daily living (ADL's). Multiple physical therapy interventions were used to restore function and independence including: patient education, electrical stimulation, short wave diathermy, manual therapy, therapeutic exercise, transfer training, gait training, balance training, and therapeutic activities.Outcomes: The patient showed improvement in transfers from dependent to Minimum Assistance/Moderate Assistance, strength of B hip flexion from 3/5 to 4-/5, strength of B knees and ankles from 3+/5 to 4-/5,sitting dynamic balance from F- to G, standing dynamic balance from unable to F, and standing activity tolerance from unable to 6 minutes. Discussion: The patient's improvement could be attributed to motivation to improve and active participation in therapy before the patient was unexpectedly discharged to the hospital.