Kyle arrived at the Pathways Program at Louisville East Post Acute with a traumatic brain injury (TBI) and multiple complex diagnoses, including DKA, seizures, and acute respiratory failure. Prior to these diagnoses, Kyle was fully independent with his daily activities, mobility, leisure pursuits, and work skills.

When Kyle began the program, Physical Therapy assessments showed his lower body strength and range of motion were within normal limits. However, due to significant challenges with coordination, balance, and safe mobility, he required maximum assistance for movement and was at a very high risk for falls. His impulsiveness combined with his physical strength made mobility particularly challenging.

Occupational Therapy evaluations found Kyle needed maximum assistance with most activities of daily living (ADLs) and total assistance for lower-body ADLs. He also experienced difficulties with sensory processing, fine motor coordination, attention to tasks, and following directions.

Speech Therapy completed comprehensive cognitive, speech, and swallow evaluations. Kyle presented with decreased oral and pharyngeal function, coughing during oral intake, aphasia, severe cognitive deficits, decreased speech intelligibility, and limited social communication.

Recreational Therapy also assessed Kyle and determined he required maximum to total assistance to participate in leisure activities.

Through the rigorous Pathways Program—which includes approximately three hours each day of Physical, Occupational, and Speech Therapy, along with daily Recreational Therapy and weekly Neuropsychological Therapy—Kyle has made remarkable progress.

Today, Kyle is walking and performing dynamic mobility tasks with contact guard assistance and is progressing toward supervision level. He is now completing his ADLs with supervision, and his balance and sensory processing have significantly improved.

Kyle’s cognition and speech have also advanced to supervision level for auditory and reading comprehension, as well as motor speech and verbal expression. He continues to work diligently on problem-solving and memory skills, which have improved to mild-to-moderate deficits. His swallowing strength has improved as well, and he is now enjoying a regular diet with thin liquids.

Kyle now participates daily in recreational therapy activities such as crossword puzzles, watching TV, and reading.

Kyle has been incredibly impressive in the Pathways Program. When reflecting on his experience, he shared, “The program makes me think in new ways each day.” When asked about his goals moving forward, Kyle said, “My goal going forward is to not stop thinking and assessing the way I move.”

Dwight “Todd” had been experiencing right side weakness, facial droop, and inability to speak when he went to University of Kentucky emergency room for evaluation on December 18, 2024. It was determined that Todd had suffered a severe left basal ganglia stroke.

Once he was medically stable, Todd began his stroke rehabilitation at Cardinal Hill Rehabilitation Hospital. His rehabilitation team there felt he would be a good candidate for the Pathways Program at Louisville East Post Acute. He transitioned to Pathways in March of 2025. Todd was assessed by Physical, Occupational and Speech Therapy.

At evaluation the physical therapist determined Todd had decreased strength right lower extremity and poor dynamic standing balance. He required maximum assistance to perform sit to stand and was able to ambulate in the parallel bars for 5 feet with minimal assistance.

His Occupational Therapy evaluation indicated he required 50% assistance with grooming and upper body dressing. Lower body ADLs including toileting required 100% assistance.  He required 2 people to transfer to the toilet. His right Upper extremity had no strength and no range of motion.

Speech Therapy assessment stated he had little to no ability to verbally communicate.  He had moderate cognitive deficits according to cognitive standardized tests. He was nothing by mouth, unable to swallow safely.

Todd began his therapy program at Pathways that also included Recreational Therapy and Neuropsychological Therapy. He attended therapy 5 days a week for at least 3 hours a day or more. Todd with a smile on his face and unfaltering dedication began to progress. Little by little towards his goals of independence.

At discharge from the Pathways program, Todd was walking around the unit with a single point cane unlimited distances and improved his lower extremity strength to perform stair climbing 15 steps.

In Occupational Therapy he was trained in the use of adaptive equipment and compensatory techniques and is now able to perform all of his basic ADLS with modified independence. He is also able to perform household tasks!

Todd no longer has restrictions with swallowing and can consume a regular consistency diet and thin liquids. The speech therapist trained him on the use of a Lingraphica TouchTalk AAC device which assists him to make all of his wants and needs known. He made significant improvements with his cognition, scoring a perfect score on the standardized test indicating cognition within normal limits.

We are so proud of Todd and all of his accomplishments and we will miss his smiling face!

Anthony was admitted to the Louisville East Post Acute Pathways Traumatic Brain Injury program after sustaining a subdural hematoma following a car accident. Anthony also suffered from aphasia and right-sided weakness from the hematoma. Anthony’s prior level of function was independent with ADLs, home/leisure, and community management, and functional mobility. When he arrived at Louisville East Post Acute, he required total to maximum assistance with ADLs and mobility.

Anthony participated in Physical Therapy. At evaluation he was unable to perform sit to stand or walk due to spasticity and limited movement in bilateral lower extremities. He scored a 7 on the Physical Mobility Scale, indicating severe limitations in movement. At discharge, Anthony made tremendous gains in his mobility. He was independent with walking; at times, he uses a single tip cane. His score on the Physical Mobility Scale increased to 41, indicating a low risk of falls and mild mobility impairments.

Anthony’s Occupational Therapy program was very successful! At evaluation, he was dependent with toileting and maximum assist with lower body ADLs. He scored a 19 on the Modified Barthel Index Scale, indicating he required total maximum assistance with all of his ADLs due to a decrease in cognition and movement. At discharge, he improved that score to 94, indicating mostly modified independence with ADLs. Speech Therapy was also a part of Anthony’s program on Pathways. Anthony, at evaluation, had great difficulties with recall and problem-solving. He scored a 17 on the SLUMS cognitive assessment, indicating he had moderate cognitive deficits.

At discharge, he improved his score to 30, which indicates cognition within a functional level for ADLs and community/leisure activities. Anthony worked very hard and diligently to work toward independence with ADLs, and with the care and encouragement of our PT, OT, ST, and recreational therapist, he was able to reach his goals.

Congratulations Anthony!