Terry’s rehab therapy success story
Terry first came to Rennes Health & Rehab Center for physical therapy approximately 19 months ago; he was in a work accident and rolled his milk truck over. He underwent ankle surgery and had hardware put in has ankle due to multiple fractures. Since that surgery, it has been a long road to recovery, including wound vac placement to assist with wound healing, non-weightbearing to his left foot for extended time periods, surgical management of the wound, removal of ankle hardware, infections, and eventual left below knee amputation.
Physical therapy (PT) has many realms and when it came to Terry, we needed all realms. These realms included: desensitization training, therapeutic exercise, therapeutic activity, balance training and gait training.
Desensitization training is when the therapist chooses fabrics of all textures and gently brushes the limb to decrease the intensity of his pain. This technique allows the nerves in the amputated limb to receive different inputs, which over time will allow Terry’s pain to decrease and prosthetic use can become more comfortable and natural. Once Terry could tolerate all textures, we focused on range of motion and strengthening of his arms, trunk, and both legs.
Terry’s individualized plan
Terry’s therapy included extensive therapeutic exercise as his residual limb required stretching into hip extension to ensure when a prosthetic was received, he could safely stand on it. Over time, PT had Terry in every position including lying on his back, stomach, on all fours– all aimed at stretching and strengthening to ready him for prosthetic.
Therapeutic activity includes an emphasis on transferring from one surface to another, positioning a wheelchair, locking brakes on wheelchair and floor transfers. Terry progressed fast to an independent level with his wheelchair mobility and transferring.
Balance training was also key to Terry’s long-term comfort and safety. On one leg, Terry’s max standing time was 20 seconds. However, to improve his body’s response, PT focused on standing upon soft surfaces, standing on incline/declines, standing with both hands on a walker and eventually standing with a single point cane.
Learning to walk again
During Gait training our goal was to help Terry regain natural mobility. The one thing PT did not focus on much was hopping due to pain in both of his wrists. We instead waited until Terry received a diagnostic socket also known as a test prosthetic leg to assess fit and foot/ankle settings. Once Terry received that first leg, we packed PT into 1.5 weeks focusing on walking outside, walking up/down stairs, walking on grass, walking with a walker, and walking with a cane. We concreted his treatment during this time because once that time was up, that prosthetic leg would go back to the prosthetist for final adjustments. Terry waited 1 month to receive the final prosthetic.
Upon receiving his final prosthetic leg, Terry went home 4 days later. On this last day of therapy, Rennes Health & Rehab Center-De Pere therapy, nursing and social work all gathered in the therapy gym to applaud Terry on all his hard work. On discharge, he was independent with all tasks using a walker and could also use a cane. Terry will complete outpatient physical therapy in Crivitz where he is from and his main goal is to walk without a device, and be able to walk in his yard again.
“It was a pleasure to work with Terry for 4 months after his amputation as he greatly challenged me to be more creative with interventions to ensure he was ready for discharge. Working with Terry made me a better physical therapist and will benefit me going forward to think out of the box with all patients!” said Sydney Schultz PT, DPT
