Background and Purpose: Brainstem strokes are much less common and have a higher mortality rate than cortical strokes. Brainstem strokes can lead to several physical impairments, including gaze palsies, quadriplegia, ataxia, or cranial nerve deficits, leading to decreased balance and safety as well as decreased independence with functional activities. The purpose of this case report is to provide an overview of the physical therapy care plan created for a patient with chronic brainstem strokes. Case Description: The patient is a middle-aged man who had two brainstem strokes over two years ago. He initially received physical, occupational, and speech therapies, then learned he had kidney cancer. After removal of his kidney, he remained unable to walk for two years. The patient chose to return to physical therapy services with the goal of improving his mobility. Examination revealed deficits in lower extremity functional strength, right sided upper and lower extremity sensation and proprioception, standing balance, transfers and ambulation, as well as visual impairments, ataxia, and right-sided hemiparesis. Therapeutic interventions including aquatic therapy, use of a bodyweight support system, and specific task practice were provided to address his deficits, with an emphasis on improving his functional mobility. Outcomes: The patient improved his activity tolerance, balance, bed mobility, transfers, and gait. However, because of his stroke-related impairments, he was unable to ambulate without assistance or supervision. Discussion: The patient made gains with physical therapy. Further research and case reports are needed regarding rehabilitation and physical therapy management for patients with brainstem strokes in order to determine more effective methods for improving functional mobility for this population.
Flahaven, Kelley, "Physical Therapy Management Of A Patient With Chronic Brainstem Stroke Syndrome To Improve Functional Mobility: A Case Report" (2016). Case Report Papers. 63.