© 2014 Erin Bayne
Background and Purpose: Stroke is the leading cause of long term disability in the United States. Hemiparesis is an impairment following stroke, however trunk musculature asymmetry is also common and is often overlooked when assessing a patient’s muscular control. Trunk musculature is an essential link between the upper and lower extremities during activities of daily living and impairments in trunk musculature can result in decreased safety and balance. The purpose of this case report is to provide the framework for treatment and an overview of the care plan for a patient following stroke, with special attention to trunk musculature facilitation. Case Description: The patient was an elderly woman diagnosed with a right cerebrovascular accident and left hemiparesis. She spent 18 days in acute care rehabilitation where she received daily physical, occupational, and speech therapy. She was transferred to a skilled nursing facility for continued therapy services, which she received 5-7 days per week for 8 weeks. She initially presented with deficits in functional mobility, transfers and ambulation, inattention to her left side, decreased activity tolerance, and increased fall risk. Therapeutic interventions were provided with special attention to tactile facilitation of the left trunk musculature. Outcomes: The patient improved her activity tolerance, muscle activation, muscular endurance, bed mobility, transfers and gait and was discharged to home. However, because of cognitive changes following her cerebrovascular accident, it was highly recommended that the patient continue to receive 24-hour supervision and care. Discussion: Physical therapy has the potential to make significant improvements in a patient’s overall function and with proper muscular facilitation techniques patients may make even greater gains during their time in rehabilitation.
Bayne, Erin, "Physical Therapy Management Of A Patient With Stroke Utilizing Muscular Facilitation Techniques In A Skilled Nursing Facility: A Case Report" (2014). Case Report Papers. 18.