Document Type

Case Report


Physical Therapy & Rehabilitation Science

Degree Name

DPT (Doctor of Physical Therapy)

Session and Year of Graduation

Fall 2019


Frey Law, Laura


Background: Geriatric patients commonly present to rehabilitation having multiple co-morbidities. One example occurred in an outpatient clinic where the patient presented with a central cord lesion and knee range of motion deficits. Central cord injuries commonly lead to motor impairment, with the upper extremities being affected more than the lower extremities. The rehabilitation for addressing these two conditions often do not have much overlap. However, for patients with unrelated co-morbidities, therapists need to rely on multiple strategies to optimize patient care. Purpose: The purpose of this case report is to illustrate the outpatient plan of care, including both neurological and orthopedic strategies, for an individual with a cervical central cord lesion and bilateral reduced knee range of motion. Case Description: The patient was a 61-year old male who sustained a cervical central spinal cord lesion at the C1-C4 level. He had a history of bilateral total knee arthroplasties over 10 years ago, with notable knee range of motion and functional limitations. He achieved 40 degrees of knee flexion on the left and 85 degrees of knee flexion on his right at initial evaluation. Intervention: Neurological interventions of task specific repetitive practice along with orthopedic interventions of joint mobilizations and exercise were administered with the patient. Outcomes: Outcomes used included: 10 Meter Walk Test, 5x Sit to Stand, Lower Extremity Functional Scale, and goniometry. Discussion: The patient improved in all outcome measures and reported improvement in home and community function. This is one case outlining a patient with both neurological and orthopedic impairments, thus further research into patients with multiple co-morbidities is warranted to improve clinicians’ evidence-based approach and provide optimal patient care.


Central cord lesion, knee range of motion, outpatient neurological, outpatient orthopedic, physical therapy rehabilitation


11 pages


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