(ANECDOTAL CLINICAL RESULT)
COMORBIDITY (EDEMA, WEAKNESS, RESPIRATORY DISTRESS, CHF)
A 92 year old female, had been on a maintenance physical therapy regimen for approximately 3 years, engaging a physical therapist twice weekly to keep her independent functional status and support continuing to live at home. In early September 2014 the therapist noted a decrease in her ability to tolerate exercise and ambulation and increasing breathlessness with exertion. Also noted was an increased level of edema in her lower extremities, more pronounced in her right leg. After 2-3 weeks of witnessing her weakness, breathlessness, and lower extremity swelling slowly progress, and with prior experience in observing this downward spiral suggestive of congestive heart failure (CHF), which often would culminate in a fall in this population, the therapist met with her sons who function as her care providers. The therapist recommended increasing Effortless Exercise™ sessions with her TREDLR™ to meet the standards of Treadwell’s CHF protocol. Until this point in time she had engaged the Treadwell® System sporadically for three years. Her sons agreed to get her on the prescribed schedule, which was implemented immediately. The next visit by the therapist was 4 days later, at which time less breathlessness was noted with exertion. The second visit, 7 days after initiating the CHF protocol, breathlessness was no longer noted, and her tolerance for exercise and activity returned to pre-episode levels. Edema in the legs was also decreased, visibly and by palpated tension in the lower legs. The patient has had some level of lower extremity edema for several years that has caused a loss of elasticity in the tissues, allowing the appearance of fluid accumulation to be present. The patient’s gait showed immediate improvement with respect to foot clearance and step length. This was also observed and noted by her sons.
Richard Hand, PT