Perspective from Physical Therapy
unmanageable at home. Their co-morbidities are
often irreparable and greatly impair their recovery
from simpler, normally easily manageable
dysfunctions. These are patients who have
recently had an obvious decline in functional
level, a fall, or needed to be admitted to the
hospital for a few days, and have returned. One
gentleman with advanced Parkinson’s developed
aspiration pneumonia and returned with a
feeding tube. Another lady with 30-degree knee
contractures lost the ability to transfer or walk
after some medication changes. They’re also not
going home, and not in a hurry.
Gait is an important issue as it is the basis for
ambulation and their eventual return home. Gait
patterns are thoroughly assessed during their
evaluation, but every time someone stands to
walk, they are continuously being re-evaluated.
The evaluating therapists and assistants greatly
"Many of the
long-termcare (LTC)
patients have
conceded to
their conditions
and are a little
less motivated
because
they are not
returning to
the homes they
came from."
34
Pedorthic Footcare Association www.pedorthics.org
Photo from: @iStock.com/KatarzynaBialasiewicz
therapist if there are issues with speech and
eating.
There are numerous conditions that are treated
here. Currently, there is one patient with an
open reduction femur fracture with Alzheimer’s,
and a rotator cuff tear on the RT side. To make
matters more interesting, she recently had a
CVA affecting the LT side, and a UTI. There is
a patient with intractable back pain and severe
addiction problems. And a younger patient with
a Charcot ankle and foot fracture. STR patients
tend to be more motivated as this new level of
dysfunction is disturbing to them. Many of the
LTC patients have conceded to their conditions
and are a little less motivated because they are not
returning to the homes they came from.
There are not many differences between
the LTC and STR populations. Many have
pre-existing pathologies that make their lives