Publication Date

Spring 2015

Document Type

Project Summary

Degree Name

Doctor of Physical Therapy

Department

Physical Therapy

First Advisor

Russell E. Carter, PT, Ed.D.

Second Advisor

Tim Rylander, PT, OCS

Third Advisor

Antonia Christian, PT

Abstract

Background & Purpose: There is currently a lack of research for physical therapy as an intervention in the treatment of Legg-Calve-Perthes Disease. The purpose of this case report is to explore the effectiveness of conservative physical therapy intervention for a 17-year-old female diagnosed with Legg-Calve-Perthes Disease.

Case Description: This case report includes the examination, evaluation, and treatment of a patient with Legg-Calve-Perthes Disease. Interventions focused on increasing strength and range of motion of the left lower extremity, improving balance and proprioception, and the incorporation of functional activities. To measure the effectiveness of the intervention the following examinations where used: Lower Extremity Functional Scale (LEFS) to evaluate the effects of the disease on the patient’s function, Classification Instrument in Perthes (CLIPer) to assess the involvement (mild, moderate or severe), Numerical Rating Pain Score (NRPS) to assess the level of pain, Manual Muscle Testing to assess strength and Goniometry to measure range of motion.

Outcomes: After a total of 14 visits over 9 weeks, the patient demonstrated improved range of motion for hip flexion, abduction, internal and external rotation for the involved leg. Strength of the involved lower extremity also improved for all muscle groups tested. Other noted improvements included improved balance and decreased reliance on an assistive device. The patient made progress towards each of her goals, but did not fully meet any of them. She also indicated an increase in pain over the course of this study that limited her functional abilities.

Discussion: The results of this study confirm the findings of previous literature and make the case for physical therapy as an effective means of conservative management of Legg-Calve-Perthes Disease. This study also serves as an example of the clinical implementation of the principles found in Evidence-Based Care Guidelines for Conservative Management of Legg-Calve-Perthes Disease. Future research should investigate the effectiveness of other modes of physical therapy such as aquatic therapy, the use of physical agents, as well as using physical therapy in combination with the use of an orthotic device.

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