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On Your Feet in 3℠ Program
Patient Case Study


Judith is a 69 year old patient admitted to Great Lakes Caring Home Health status post hospital
discharge due to osteoarthritis of right knee, which was treated with a total knee replacement.
She presents with impaired gait, strength, balance, and limited range of motion in her right knee.
Pain is moderate to severe with all movement. She has limited flexion and strength also. She is
unable to return to her home until she can walk and navigate stairs. She will be staying with her
sister until she becomes independent again. Judith’s prior lifestyle was very active and independent.

Judith was identified as a candidate for Great Lakes Caring Home Health On Your Feet in 3℠
Evidence Based Practice (EBP) program. This EBP program for knee and hip rehabilitation is
designed to get patients up and moving faster in as little as three weeks following joint replacement.
Increased frequency of physical therapy visits were performed for Judith almost daily, for range of
motion, increased strength, return to functional mobility and appropriate gait pattern.
Instructions for pain management, use of ice to decrease swelling, use of a Continuous Passive
Motion (CPM) machine, and stretching/strengthening/gait exercises were taught. These
interventions provided Judith with increase range of motion and decreased pain. By the fifth
visit, flexion of her knee increased significantly, and by the seventh visit she had progressed to her
physician’s goal for range-of-motion. Judith was able to manage her pain with previous education
from the physical therapist, manage swelling with use of ice and elevation.

She was able to return to her own home the second week post op. Physical therapy assessed her
at her home, provided on-going education and exercises for stair use, and with the patient’s
participation Judith was able to be discharged from all homecare services at the end of her fourth
week. With driving privileges given from her physician, she transitioned to outpatient therapy
at time of discharge.

Judith’s desire to achieve her goals were met by providing Great Lakes Caring Home Health
On Your Feet in 3℠ program. She increased her quality of life, safety and independence with
minimal risks and no complications.


Presented by Sarah Thurston, LMSW
Great Lakes Caring Director of Education
October 2017