NeuroDash

The stroke case library

subacute — tier 1

Walking is trained by walking — subacute gait dose

Patient70M, subacute phase
LesionMCA territory, moderate
SeverityNIHSS 7
Days since onset9
Before the strokeIndependent; ex-dockworker, walks to the shops daily.
Also on the chartHypertension; Atrial fibrillation
PrecautionsAFO on for all gait work; Fatigue — bouts before mid-afternoon

Test yourself

What is the gait intervention this week?

The teaching

Subacute gait is a dose decision, not an equipment decision: the evidence rewards overground repetition of the whole task, and the two ANPT core measures — speed and six-minute distance — are how the dose proves itself week to week.

Read next

The full sequence

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.

Sources on this page: Winstein CJ et al. Stroke. 2016. English C et al. Cochrane Database Syst Rev. 2017. Duncan PW et al. LEAPS. N Engl J Med. 2011 · Moore JL et al. J Neurol Phys Ther. 2018