Restoring Functional Mobility For A Geriatric Patient Following Open Repair Of A Ruptured Abdominal Aortic Aneurysm: A Case Report

Background and Purpose: Each year 200,000 people are diagnosed with an abdominal aortic aneurysm (AAA) in the United States and the mortality rate for ruptured AAA is estimated to be 80%. There are two surgical options to treat ruptured AAA, an open repair and an endovascular aneurysm repair (EVAR). The incidence of rupture following an EVAR is 0.9%. The purpose of this case report was to describe the physical therapy (PT) plan of care of an elderly patient following an open repair of a ruptured AAA with a history of EVAR. Case Description: The patient was an 86-year-old female admitted to the skilled nursing facility following an open repair of a ruptured AAA with a history of EVAR. The patient presented with the primary problems of decreased lower extremity (LE) strength, balance, and activity tolerance. Interventions focused on improving her tolerance for functional mobility through strength, gait, and balance training. Outcomes: At discharge, the patient showed improvements in her LE strength bilaterally (3+/5 [Fair +] to 4+/5 [Good +]) and her tolerance for ambulation (75 to 500 feet) with a two-wheeled walker. The patient had a small increase in her Berg Balance Scale score (34/56 to 37/56) and improved her Timed Up and Go score (25.29 to 16.75 seconds). Discussion: Strength, balance, and gait training appeared to be successful PT interventions in the rehabilitation of a geriatric patient following open repair of ruptured AAA. Due to the rarity of this specific patient case, large-scale studies are unlikely; however, due to the lack of recommendations there is a substantial need for future research into PT protocols for this patient population in general