Abstract
Background and Purpose: According to the Centers for Disease Control and Prevention (CDC) Osteoarthritis (OA) is the most common form of arthritis, it affects 33.6% of adults aged 65 and older an estimated 26.9 million adults in the US in 2005, which is up from 21 million in 1990. Eighty-eight out of ten thousand of these patients will suffer from hip OA leading to hospitalizations and potentially hip replacement procedures. Patients suffering from OA who have opted to have a total hip replacement may present with barriers to conventional land based therapy due to inability to bear full weight on the affected extremity. Evidence has shown that aquatic therapy is a good initial intervention for THA patients. The unique qualities of water make it well matched for patients who are unable to exercise on land, or find land-based activity too demanding. Aquatic therapy provides an alternative strategy (Batterham, Heywood & Keating, 2011). Case Description: The purpose of this case study is to describe the evaluation, intervention, and outcome of a patient following a THA with 3 subsequent revision surgeries who successfully participated in an aquatic therapy program. The patient is a 54-year-old male referred to physical therapy following a THA and 3 revision surgeries resulting in impaired gait positive Trendelenberg, impaired balance, and overall decrease in functional mobility and subjective pain stated 10/10 at worst and average of 6/10. The aquatic therapy sessions were three times per week for the initial 4 weeks then the patient was progressed to land based therapy for an additional 8 weeks. Results: The aquatic program included progressive strengthening, gait training, and balance activities. After three weeks, the patient reported a significant decrease in subjective pain levels and demonstrated increased static standing balance with improved hip stabilization. He also demonstrated improved strength, increased weight bearing tolerance, and increased functional mobility. Demonstrated by manual muscle testing, improved activities of daily living, and subjective increased functional mobility. Conclusions: This case report advocates that aquatic therapy may be valuable for patients with impaired weight bearing tolerance that would not be able to progress with land therapy or are unable to tolerate land activities...