Patient Case Study
Mary is a 74 year old woman who had limited range of motion (ROM) and pain in her neck and right
shoulder. Due to the limited ROM and pain, Mary was unable to perform activities of daily living
(ADLs) and was having difficulty taking care of herself. She had also recently stopped enjoying her
favorite pastime activity of knitting because of the pain. Her daughter took her to her primary
physician who diagnosed Mary with a cervical muscle strain and bursitis of the shoulder, which
resulted in muscle tightness of her upper trapezius muscle and rotator cuff.
Mary’s physician referred her to Great Lakes Caring Home Health to have her evaluated in her
home by a physical therapist. The physical therapist completed the evaluation and developed a plan
of care that included ultrasound therapy, passive range of motion (PROM), stretching and an inhome
exercise program to help return the patient to her prior level of function.
The ultrasound therapy is a treatment modality that uses ultrasound waves to penetrate the muscles
and connective tissues, providing a deep heat that aides in reducing pain, muscle spasms and
promotes tissue healing. It can also help loosen up tissue, which allows patients to respond better to
stretching or other manual techniques that the therapist might use to loosen tight joints or muscles.
Mary received ultrasound therapy at an intensity of 1.5 w/cm2, and frequency of 1MHZ to decrease
inflammation of the bursitis in her shoulder for eight minutes during each visit. Ultrasound was also
used at intensity of 1.3 w/cm2 and frequency of 1MHZ for eight minutes on the left side of her neck
to reduce pain and inflammation in the cervical muscles. The therapist performed manual stretches
after the therapy and instructed Mary on strengthening exercises and self-stretching once the pain
had decreased. The therapist also educated the patient on proper posture and body mechanics when
performing ADL’s and proper neck support during sleeping.
After six visits of therapy, Mary was pain free and had regained full range of motion in her shoulder
and neck. Mary is living by herself again and completing all ADLs independently. Mary was also
able to resume her knitting, which she had expressed was an important activity in her life.
Presented by Sarah Thurston, LMSW
Great Lakes Caring Director of Education