Physical therapy for improving fall risk with post-laminectomy syndrome after hospitalization: a case report

Background and Purpose: Post-laminectomy syndrome is not well known, and there are not many case reports on this topic relating to fall risk. Additionally, patients with sarcopenia and generalized weakness after hospitalization are at high risk for increased frailty and increased risk of falling. These patients benefit from physical therapy to combat sarcopenia, reduce chronic back pain, and decrease the risk of falling to improve their functional mobility and quality of life. Case Description: The patient is a 77-year-old male presenting with complaints of generalized muscle weakness, constant low back pain, numbness and tingling down the left leg, and poor balance and stamina with walking. PT interventions focused on lower extremity strengthening, cardiovascular endurance, core stability, and balance. Outcomes: The patient was initially prescribed physical therapy twice a week for eight weeks in addition to a home exercise program. Muscle weakness and stamina improved after 8 visits. The patient was assessed with the Focus on Therapeutic Outcomes (FOTO), Manual Muscle Testing (MMT), Timed Up and Go (TUG), Five Time Sit-to-Stand (5 STS), and Numeric Pain Rating Scale (NPRS). Upon increasing activity tolerance and stamina, the patient tolerated more gait training and standing activities with breaks. Discussion: Physical therapy interventions were helpful for this patient and were supported by research to reduce fall risk and increase either strength or core stability. The patient improved MMT scores by at least one-half for all hip measurements except for left hip flexion. The patient improved TUG time, 5 STS time, and decreased NPRS. The patient’s improvement in TUG time and 5 STS time indicates a decrease in the severity of the patient’s fall risk