Her neurologic status improves with a systolic BP of 160 mm Hg, but she continues to have difficulty speaking. Mrs. Soncini improves over the next few days. She's weaned from I.V. fluids and the nurses continue to evaluate her neurologic status. As her condition stabilizes, she begins rehabilitation with physical, occupational, and speech therapy. The goals are to achieve independence with functional mobility, cognition, self-care, and speech.
Physical therapy focuses on bed and wheelchair mobility, sitting balance, transfers, and gait.
Strengthening exercises allow functional progression. Occupational therapy focuses on deficits in Mrs. Soncini's functional cognition, perception, and vision as they affect her activities of daily living. She works on developing her fine motor skills, strengthening her upper extremities, and learning functional transfers. Speech therapy helps develop her ability to understand and communicate speech. The therapist evaluates her swallowing function and makes appropriate dietary recommendations to prevent aspiration.