This past Thursday, December 1st, my Fundamentals in Biomedical Sciences (II) class was visited by Elizabeth Boone, a physical therapist from Infirmary Therapy Services, and her student, Rachel, as a continuation of our trauma week activities. She came to discuss with us the role of a physical therapist in the treatment of a patient who suffered a severe trauma.
By the time our patient, Connor, reached Mrs. Boone, he had undergone an external fixation to the tibia of the left leg. At this time, Connor is working with Mrs. Boone to regain muscle function and begins applying load to his leg before his next surgery (the replacement of the external fixator with a rod). After his second surgery, he and Mrs. Boone will be working to regain total function of the leg.
Mrs. Boone began her evaluation by asking questions directly to the patient to gain subjective information. She asked about the injury, specifically the mechanization of injury (MOI). She then asked some questions about pain levels over the course of the injury. After the question and answer section, Mrs. Boone began to accumulate data to complete an objective report. To achieve this, she measured various parts of the leg from locations such as the quad, knee, and ankle. She compared these measurements to the patient's healthy leg to monitor swelling and to be on the lookout for conditions such as atrophy. Secondly, she checked the patient's knee and ankle mobility (also compared to the healthy leg). She recorded the degree of movement at each location and scored the mobility on a 5 point scale (5 being normal). These reports will be sent to the patient's physician and will play a role in the choice/type/intensity of rehabilitation that the patient will undergo.
Our patient complained of pain in the left knee, so Mrs. Boone decided to perform an Anterior Lachman test to check the knee for probability of an ACL tear. This test came back positive, meaning our patient had a high probability of having an ACL tear. Mrs. Boone makes sure to communicate this to our patient’s physician, so that the physician may observe this injury more closely.
Treatment for such a severe injury is a long process, so Mrs. Boone starts small with the movements that our patient will have to try. She begins by using electrical neuromuscular stimulation on our patients leg to help the nerves in the leg connect with the brain. She then decided to use dry needling in order to relax the muscles, boost blood flow, diminish inflammation, and trigger a healing response.
In a poor lapse of judgment, I chose to be her dummy for the dry needling procedure for my classmates to observe. I have quite the fear of needles. In short, I passed out, so I don’t remember class very well after that.
Despite the unfortunate turn of events, I did enjoy listening to Mrs. Boone today, and I hope she will come back again and talk more about her field.
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