Effect of Physical Therapist Management using Pulsed Short-Wave Diathermy for a Stage III Sacral Pressure Ulcer in a patient with Alzheimer’s Dementia: A 4-Week Study in a Skilled Nursing Facility: Case Report.

Alzheimer's disease (AD) is the most common cause of dementia which results in progressive decline in memory, cognitive and functional abilities of patients. Pressure ulcers are a common complication in patients with AD in skilled nursing facilities (SNF) and contribute significantly to the mortality rate.1, 2 Pulsed short wave diathermy (PSWD) treatment has been shown to promote faster healing of pressure ulcers.12 The purpose of this case report was to examine the effect of PSWD treatment on Stage III sacral pressure ulcer healing and its impact on sitting balance in an 80 year old female with advanced AD residing in an SNF. Case Description The patient was an 80-year-old female with stage 6 AD and a Stage III sacral pressure ulcer. Intervention The patient underwent 16, hour long physical therapy sessions over 4 weeks focused on localized PSWD treatment for wound healing alongside interventions to improve muscle strength, sitting balance, posture, and positioning. Outcomes Patient's sacral ulcer improved to Stage III healed, evidenced by 100% eschar and no slough tissue. Pain was effectively managed, with a final Pain Assessment in Advanced Dementia (PAINAD) score of 0. The patient's Braden Scale for Predicting Pressure Sore Risk (BRADEN) score improved to 18, indicating reduced risk for skin breakdown. The patient’s Function in Sitting Test (FIST) score improved to 46/56, indicating improved sitting balance. Discussion This case report demonstrates that PSWD facilitates faster wound healing and improved pain management in patients with AD. This case report encourages future research to validate the efficacy and safety of PSWD in similar patient populations.