Treatment effectiveness

A patient of mine (B.H.) was involved in a serious MVA and as a result suffered many orthopaedic fractures and a head injury, rending him unable to walk. As a result of his car accident and head injury, he has heterotrophic ossification (growth of bone in muscles and tendons) of his (R) hip and his (L) knee. This makes flexing his hip and knee very painful and difficult even after analgesia. 

Currently we are working on ROM of his LL's and strengthening of his UL's, LL's and trunk. Progress is very slow because of his H.O. and varying pain levels. Other joints such as his (L) hip are also affected and not getting to their full ROM because of the painful (L) knee being unable to flex. We do the same basic slideboard exercises for ROM of his LL's everyday due to B.H.'s high pain levels. I feel that he is not really benefitting from doing slideboard exercises because of the restriction in his joints that we can't treat with physio. 

I still encourage the slideboard exercises to be part of our treatment program to maintain the remaining ROM left even though it isn't improving it. This has taught me the importance of still taking into consideration problems that can't be treated via physio but instead looking from the point of view of preventing further complications which ultimately could make a difference in a patient's quality of life.