Amy J. Litterini
© 2017 Zachary Mercier
Background and Purpose: Motor vehicle accidents are a common occurrence causing increased morbidity and possible mortality, thus, increasing lifetime medical costs for those affected. The purpose of this case report is to document the selected patient's response to skilled physical therapy (PT) interventions, ranging from bed mobility tasks to ambulation, following a motor vehicle accident. Case Description: A 20-year-old female was a passenger in a severe motor vehicle versus tree accident with fatalities. The patient suffered multiple fractures throughout her skeleton and spent 20 days in a hospital prior to presenting to the skilled nursing facility. Care included high intensity PT interventions five to six days per week for a total of 50 sessions. The patient demonstrated non-compliance with her non-weight bearing (NWB) status of the bilateral lower extremities (BLE). Outcomes: The CARE Items Mobility Assessment score significantly improved from admission to discharge (18/84 to 51/84). The patient demonstrated improvements in bed mobility and functional transfers, as well as strength and endurance. The patient presented to the SNF with non-weight bearing orders for BLE and was discharged with weight bearing as tolerated in BLE, for transfer purposes only. Discussion: Improvements in functional mobility were noted over the course of care. The patient's improved outcomes and increased independence may be due to the prescription of higher intensity PT interventions. Future research should investigate the relationship of appropriate intervention prescription and non-compliance to weight bearing status, decreased motivation, and the effects of NWB status on a patient's ability to regain functional mobility and return to prior level of function.
Mercier, Zachary, "Restoration Of Functional Mobility For A Young Adult Patient Following A Severe Motor Vehicle Accident: A Case Report" (2017). Case Report Papers. 67.