The Implementation of Therapeutic Alliance in the Rehabilitation of an Elite Pediatric Athlete with Salter-Harris Fracture: A Case Report.
Lucas VanEtten, Matthew Briggs, John DeWitt and 2 others
PMID 33842050WHAT IT FOUND
In an elite pediatric athlete after knee fracture surgery, a physical therapist used shared goals, honesty about uncertainty, and sport-specific compromise to maintain engagement; he improved knee motion and returned to racing.
Key findings
01A 14-year-old male athlete returned to hydroplane racing and won a national championship in his age group after 17 weeks and 25 physical therapy sessions.
02Week 17 measures showed knee range of motion 0-135 degrees and quadriceps symmetry 80% at 60 degrees/second and 91% at 300 degrees/second.
03Therapeutic alliance was not measured during care; at five years the subject scored 70 on the Working Alliance Inventory and the physical therapist scored 69.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a case report, so it cannot show that therapeutic alliance caused the improved function or return to sport. Cause and effect cannot be determined, and the athlete could have improved with time from surgery and without intervention. Therapeutic alliance was not formally measured during the 17 weeks and 25 sessions; the Working Alliance Inventory was completed five years later. Subject reported outcomes were not collected at the end of care because he missed his discharge appointment. Home exercise adherence was self-reported and not objectively measured. There is limited literature on post-operative rehabilitation for femoral growth plate fractures and on timing of progression.
Declared interests
The authors declared no financial disclosures or conflicts of interest.
The easy way to misread this
Do not conclude that therapeutic alliance caused the return to sport. This was a case report, cause and effect cannot be determined, and no formal therapeutic alliance measure was used during care.