Left to right: Oliver Bartolay, physical therapist; Florante Noble, director of rehab; Perry Nickle; Jyoti Dhumale, occupational therapist; Trung Nguyen, PT student; and Cindy Ballew, physical therapist assistant

Perry Nickle was admitted to Life Care Center of Escondido, California, after several hospitalizations due to a left below-the-knee amputation caused by osteomyelitis and subsequent stump infection.


Before the amputation, Nickle lived alone and functioned independently without the use of an assistive device. The surgery and infections resulted in lengthy hospital stays that reduced his ability to perform regular daily activities such as getting in and out of bed, standing, walking, self-care, showering and dressing.


When Nickle first arrived at Life Care Center of Escondido on May 3, 2018, he was unable to use his prosthetic. His left stump was hypersensitive and painful. He had been deconditioned to the point where he needed assistance with all physical tasks.


The rehab plan of care was to educate and train Nickle on proper movement sequences of self-care and gait to rebuild his functional independence. Self-care tasks were modified with use of an assistive device to decrease the work needed. Transfers and gait training began with teaching him how to hop and pivot with the aid of a walker. Therapists also used massage and modalities to desensitize his left stump for improved participation during therapy.


Within several weeks, Nickle’s new prosthetic leg arrived. His new plan of care was to learn prosthetic management. He learned how to don and doff his prosthetic leg. He is now able to tolerate the prosthesis for up to two to four hours. Daily activities such as getting in and out of bed and standing improved to the point where he needs no physical assistance.


As Nickle’s walking improved, he graduated from a front-wheeled walker to a rolling walker and began stair climbing training to prepare for the steps inside his home. By the time he returned home, he was able to perform all daily activities independently and safely with the use of his assistive device.


“Perry’s greatest fear after the amputation was that he might never walk normally again,” said Florante Noble, director of rehab. “He feels blessed that the Lord brought him to Life Care, where he met his rehab team. He credited his ability to walk again to the ‘encouragement and knowledge of the rehab team.’ Perry realizes he will not have the rehab team there when he is home, but he is optimistic that he can encourage himself to continue improving his quality of life by incorporation the lessons and experiences he has gained at Life Care Center of Escondido.”


Nickle returned home on June 13.

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