Faculty Advisor(s)

Kirsten Buchanan

Document Type

Course Paper

Publication Date



© 2017 Kathryn Judd


Background and Purpose: Ankle fractures are one of the most common injuries amongst the elderly, with an incidence rate of approximately 174 cases per 100,000 persons per year. Balance training has been a typical component of a physical therapy (PT) program following ankle fractures. Fall prevention programs have been shown to decrease fall risk by 13% to 40%. There is limited research investigating a combined balance training and fall prevention program after an ankle fracture. Therefore, the purpose of this case report was to describe a PT program combining balance training and fall prevention strategies for an elderly patient after a trimalleolar fracture. Case Description: The patient was a 77-year-old female who sustained a left (L) trimalleolar ankle fracture which was surgically corrected. The patient received PT twice per week for 15 weeks. The PT plan of care included balance exercises and a fall prevention program, incorporating mobility, strength, and minimizing environmental hazards. Outcomes included Lower Extremity Functional Scale (LEFS), Dynamic Gait Index (DGI), active range of motion (AROM), and girth measurements. Outcomes: The LEFS improved from 37/80 at initial evaluation (IE) to 59/80 discharge and the DGI improved from 17/24 to 20/24. AROM improved in all planes: dorsiflexion (-4 to 10 degrees), plantarflexion (24 to 52 degrees), inversion (20 to 25 degrees), and eversion (14 to 20 degrees). Ankle swelling decreased from 49 centimeters (cm) to 46cm. Discussion: A rehabilitation program that combined balance exercises and fall prevention strategies was beneficial for this patient after a trimalleolar fracture. Future research should consider investigating the effectiveness of a combined balance program with fall prevention strategies in a larger population of older adults following ankle injury.


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