Post-acute rehabilitation of a patient with traumatic brain injury and history of chronic stroke

A patient with traumatic brain injury and a history of chronic stroke was seen for physical therapy treatment for 40 sessions over 2 months in a skilled nursing facility in Northern California. Treatment sessions were provided by a student physical therapist under the supervision of a licensed physical therapist. The patient’s bed mobility, transfers, and gait were examined at the time of the initial encounter. During this episode of care, the Tinetti Performance Oriented Mobility Assessment, 10-Meter Walk Test, and 2-Minute Walk Test were used to assess his balance and mobility. Impairments, activity limitations, and participation restrictions were identified, and a plan of care was established. The primary goals for the patient were to improve balance, strength, functional mobility, and gait. Primary interventions included therapeutic exercise, task-specific training, and gait training. The patient improved in balance, strength, bed mobility, transfers, and gait. He also increased his functional independence, and was able to engage in more social activities. At the time that the student physical therapist concluded involvement in this case, the patient continued to receive physical therapy to further optimize his function and quality of life.