The first stand — subacute hemiparesis

At day 16 the window is wide open and the dose decides. The sequence that holds: re-check the limiter (balance and symmetry), measure the thing you are training (Berg), prescribe task-specific practice at a real dose, and turn the family into safe practice partners. The shoulder is intact and cognition is intact — the discipline is leaving them alone and spending the session where the loss is.

• Ankle dorsiflexion at 3+ — watch for foot drop as gait starts; an AFO review belongs in next week’s plan, not this one’s.
• Diabetes and hypertension — monitor the exertion response. Moderate intensity is a ceiling here, not a target to exceed.
• Berg 32/56 sits inside published fall-risk bands — the falls-risk conversation with the team should be documented, not verbal.

• The flaccid arm — protecting the shoulderTier 2
• Eight months out — the plateau that isn’tTier 4

This page carries the case’s first decision. The full sequence — every decision, the five-domain examination, and the debrief that grades you — is in the drill, and the library is included with membership.