Abstract
A 76-year old female patient who was 5 days post left cerebral hemispheric ischemic stroke was seen for physical therapy treatments for 34 sessions during a 17-day period at an inpatient rehabilitation center. Physical therapy treatment was provided by a student physical therapist under the supervision a licensed physical therapist. At the initial encounter, 5 days post-ischemic event, the patient was evaluated using manual muscle testing, the Functional Reach Test, 10 Meter Walk Test, Five Times Sit to Stand, and the Functional Independence Measure. The patient presented with right sided weakness, expressive and receptive aphasia, impulsivity, the inability to follow multi-step commands, and emotional lability. She had decreased strength, decreased static and dynamic balance, and limited community ambulation. She was unable to walk independently in her room and was unable to participate in community outings. The main goals for the patient were to improve strength and motor control during functional activities, gait speed, static and dynamic balance, and functional independence. Primary interventions included over-ground gait training and task-specific balance training with a neurodevelopmental approach. The patient made clinically relevant improvements in static and dynamic balance measures as well as functional independence and clinically meaningful improvements in gait speed, functional strength, and motor control. The patient was discharged home with a four-wheeled walker and home exercise program with home health physical therapy with recommendations to follow up with outpatient physical therapy.