Event Title

Outpatient physical therapy intervention for a patient with chronic compensatory adaptations in gait following a first MTP joint arthrodesis; a retrospective case report

Location

Hall of Governors

Start Date

7-4-2017 4:00 PM

End Date

7-4-2017 6:00 PM

Description

Background and purpose: Background and purpose: First MTP joint arthrodesis is the most common treatment of Hallux Rigidus. Patients are interested in alternative options to maintain motion at the first MTP joint. Conservative treatment is often ignored. Physical therapy intervention has been researched to be effective in treatment of hallux rigidus, yet research is limited in relation to treatment following compensatory movement patterns associated with the diagnosis. The purpose of this case report is to retrospectively analyze the results of a physical therapy treatment program for an individual with chronic compensatory gait adaptations at the foot following a first MTP joint arthrodesis. Case Description: The patient was a 43 year old male who initially experienced a closed fracture of the first phalange of the left foot. The patient received surgical intervention of a left 1st MTP titanium pin five years following the initial injury. Patient presented to physical therapy with compensatory adaptations in gait including increased supination and elevated first ray. The patient's primary complaints included pain at the left toe, lower leg and foot muscle spasms, and stiffness at the left foot. A plan of care was developed to improve functional limitations and mobility of the left foot.

Outcomes: At the final assessment of this retrospective case report, the patient demonstrated improvement in reported pain, muscle strength, AROM, PROM, and gait mechanics. The patient also demonstrated a clinically significant improvement in the Foot and Ankle Ability Measure.

Discussion: This case report suggests that physical therapy may be a useful conservative treatment option in patients with compensatory gait adaptations following a first MTP joint arthrodesis.

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Apr 7th, 4:00 PM Apr 7th, 6:00 PM

Outpatient physical therapy intervention for a patient with chronic compensatory adaptations in gait following a first MTP joint arthrodesis; a retrospective case report

Hall of Governors

Background and purpose: Background and purpose: First MTP joint arthrodesis is the most common treatment of Hallux Rigidus. Patients are interested in alternative options to maintain motion at the first MTP joint. Conservative treatment is often ignored. Physical therapy intervention has been researched to be effective in treatment of hallux rigidus, yet research is limited in relation to treatment following compensatory movement patterns associated with the diagnosis. The purpose of this case report is to retrospectively analyze the results of a physical therapy treatment program for an individual with chronic compensatory gait adaptations at the foot following a first MTP joint arthrodesis. Case Description: The patient was a 43 year old male who initially experienced a closed fracture of the first phalange of the left foot. The patient received surgical intervention of a left 1st MTP titanium pin five years following the initial injury. Patient presented to physical therapy with compensatory adaptations in gait including increased supination and elevated first ray. The patient's primary complaints included pain at the left toe, lower leg and foot muscle spasms, and stiffness at the left foot. A plan of care was developed to improve functional limitations and mobility of the left foot.

Outcomes: At the final assessment of this retrospective case report, the patient demonstrated improvement in reported pain, muscle strength, AROM, PROM, and gait mechanics. The patient also demonstrated a clinically significant improvement in the Foot and Ankle Ability Measure.

Discussion: This case report suggests that physical therapy may be a useful conservative treatment option in patients with compensatory gait adaptations following a first MTP joint arthrodesis.