Outpatient treadmill-based locomotor and dynamic balance retraining after intraoperative stroke

A patient that experienced an intraoperative left cerebrovascular accident was seen for physical therapy treatment for 10 sessions from 07/24/2014 to 08/27/2014 at an outpatient physical therapy clinic. Treatment was performed by a student physical therapist under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with the timed Ten-Meter Walk Test, 4-Item Dynamic Gait Index, Modified Clinical Test of Sensory Interaction on Balance, and functional tests of strength, mobility and balance and a plan of care was established. Main goals for the patient were to improve gait speed and function, ambulate safely without an assistive device, and to improve static and dynamic balance. Main interventions included body-weight supported treadmill training and high repetition, task-specific gait, strengthening and balance training. The patient achieved the following goals: improved gait speed and functional level of walking without an assistive device, improved dynamic and static balance, increased functional lower extremity strength, and greater independence with activities of daily living. The patient was discharged from physical therapy with a home exercise program and referred to occupational therapy for continued treatment of upper extremity function.