Amy J. Litterini
© 2017 Hannah Wilder
Background and Purpose: Stroke affects approximately 800,000 people annually and alterations in gait is one of the most noted impairments following stroke. The purpose of this case report is to outline physical therapy (PT) rehabilitation that utilized postural control training, task-oriented training, and visual feedback to address walking ability and functional capacity in a patient following a stroke. Case Description: The patient was a 67-year-old male apple orchard owner three months post a lacunar ischemic stroke affecting the posterior limb of the internal capsule, the basal ganglia, and part of the cerebellum. His initial examination revealed impaired strength, sensation, range of motion, balance, endurance, and mobility. This case report describes his initial ten outpatient PT visits primarily focused on improving the patient's functional mobility, ambulation in particular, through postural control training and task-oriented training. Outcomes: After ten outpatient visits, the patient demonstrated improvements in gait and postural symmetry on observation. Improvements were shown in both gait speed (from 0.24 m/s to 0.30 m/s) and gait endurance (from feet to 130 feet) and although the improvements did not meet established minimally important clinical difference values, he did demonstrate trends toward improvement. Discussion: Postural control training and task oriented training are common PT interventions utilized in patients following stroke. Utilizing postural control training and task-oriented training, the patient showed initial improvements in postural symmetry and gait mechanics, which translated to improved access to his environment. Despite initial improvements, the patient’s various comorbidities likely contributed to his plateau in progress. Future research on lacunar stroke should address how comorbidities affect the acquisition of PT goals and improvements in gait speed.
Wilder, Hannah C., "Utilization Of Postural Control Training To Improve Gait Symmetry And Walking Ability In A Patient Following A Lacunar Stroke: A Case Report" (2017). Case Report Papers. 69.