Prioritizing treatment

While at my recent neuro prac I was treating some patients who were functioning at a high level but still had some large deficits and as a result had developed some problematic compensations. One patient in particular was very motivated to progress and was getting quite frustrated with his perceived 'lack of progress' and didnt quite understand why we had him doing so much trnk exercises when it was his leg that he felt to be affecting his walking. This patient was still using an AFO and had quite a pronounced limp while walking. He had also developed trunk compensations and circumduction of the leg to get the foot clearance he needed. In hospital this patient had gotten up and started walking very early on a pulpit frame which seemed to be the reason for his pronounced compensations. This highlighted to me how important proper physiotherapy is in these early stages in decreasing the development of compensations. It was very hard for the patient to understand though as he felt that he was just being held back. I found I often have the view of progressing the patient to the hardest task possible (such as walking for this patient) thinking that this is what is going to make him best in the long run. But looking at this patient over the few weeks that i treated him I realised how important it is that you work on all of the trunk and movement control exercises in order to be able to them progress to walking with the appropriate tools in order to walk AFFECTIVELY rather than just safely. I spent alot of time trying to explain this to the patient and found that it also cleared out my own thoughts. It has changed how I will prioritize treatment and how I progress in the future.