Abstract
A 75-year-old female patient who was 21 days post ischemic stroke involving the left corona radiata and basal ganglia was seen by a student physical therapist for treatment lasting 20 sessions over a 4-week period at a skilled nursing facility under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter using manual muscle testing, the modified Ashworth scale, functional independence measure, and the stroke impact scale. Based on the evaluation, a comprehensive plan of care was developed to target the right-sided weakness and the constrained ability to perform bed mobility, transfers, and ambulation, independently. The primary goals of the treatment revolved around enhancing the patient's safety when performing transfers and reducing the burden of care to facilitate a safe discharge to home. To attain these goals, physical therapy interventions primarily utilized over-ground gait training, task-specific transfer training, and functional mobility training. At discharge, the patient was found to make clinically-relevant improvements in lower extremity strength, postural control, functional independence, and the patient’s family was competent in providing safety with all basic functional mobility. The patient was subsequently discharged to live with family with arrangements for 24-hour supervision, a home exercise program, appropriate durable medical equipment, and a recommendation to pursue follow-up care with home health services.