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Keywords

Health Care Competency, Disablement Model Case Study

Abstract

This disablement model case study outlines a 21-year-old female collegiate lacrosse player attending a United States service academy who presented with a unique neuromuscular deficit following a conservative grade II PCL tear rehabilitation. Nearing the end of her rehabilitation protocol, she noticed difficulty with toe-off while running; however, she did not report to the athletic trainer due to the institution’s holiday break proximity. An unexpected transfer of care occurred when the patient returned after the holidays, and she was cleared for full participation upon return. Several days after the patient was cleared, she reported her ankle feeling “stuck.” Upon evaluation, passive plantar flexion was significantly greater than active plantar flexion, and the patient was diagnosed with a plantar flexion lag. She was treated using Russian electrical stimulation, resisted range of motion exercises, and proprioceptive neuromuscular facilitation with D1 and D2 patterns of the lower extremity. Throughout this process, the patient was required to participate in physical fitness tests to graduate from the institution. The use of patient-reported outcome measures at this time may have been beneficial for discovering aspects of the patient's quality of life that were not explicitly assessed over the course of the patient's care and learning more about the patient's function. In addition, the abrupt transfer of care between athletic trainers left room for aspects of the patient’s case to be overlooked. Sequelae may have developed due to compensation and could have possibly been avoided if the injury had been initially addressed through the ICF model. When working with the military population, considering the added injury implications for service members is crucial when developing a treatment plan.

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