Gait Training Strategies Used to Improve Walking Ability in a Patient with Ataxia Following Stroke: A Case Report

Background: Stroke is a leading cause of disability in the world. It affects greater than 790,000 people per year in the United States. Walking ability has important implications for health and only 37% of stroke survivors can walk the first week post stoke.⁴ Thus, the purpose of this case report is to highlight common gait interventions used in an inpatient rehabilitation setting to treat impaired coordination and improve gait quality following stroke. Case Description: The patient is a 53-year-old Hispanic male admitted to inpatient rehabilitation following acute hospitalization for right cerebrovascular accident with hemiparesis. The patient presented to the emergency department five days prior for progressive left leg weakness. An MRI confirmed a small late acute to subacute infarct of right posterior internal capsule causing impairments in gait, mobility, balance, strength, sensation, activity tolerance, coordination, and motor planning. Intervention: Physical therapy focused on advancing gait and other functional tasks such as bed mobility, transfers, stairs, and wheelchair mobility. By discharge, the patient’s goals had all been resolved and he was deemed appropriate for home with family assistance. The patient was able to ambulate with standby assist using a wheeled walker and an ankle foot orthotic (AFO). He could propel a manual wheelchair with modified independence, complete all basic household transfers with modified independence, and negotiate stairs with minimal assist for improved ability to enter and exit home. Outcome Measures: The primary measures considered for this patient were assistance level, walking speed, endurance, and balance. Discussion: This case report demonstrates an example of a positive outcome following ongoing gait training and orthotic management for improved safe ambulation and functional mobility.