Amy J. Litterini
© 2019 Victoria Dwyer
Background and Purpose: Although many patients who have had a stroke receive inpatient rehabilitation treatment, there is limited literature that investigates the interventions utilized to treat this population. The purpose of this case study was to describe the inpatient rehabilitation treatment interventions including body weight supported treadmill training (BWSTT), functional electrical stimulation (FES), balance, and lower extremity (LE) strengthening on a patient with a sub-acute right middle cerebral artery (R MCA) stroke. Case description: The patient was a 43-year-old male who recently had a R MCA stroke. He presented with significant expressive aphasia, left-sided hemiparesis, balance and transfer deficits, and impulsivity. His plan of care incorporated BWSTT, FES, balance and cardiovascular training, LE strengthening, education, and over-ground walking. The outcome measures utilized were the Functional independence measure (FIM), and the Postural Assessment Stroke Scale (PASS). His reflexes, gross motor strength, and sensation were also assessed. Outcomes: The patient demonstrated improvements in his left LE (LLE) strength from averaging 2/5 to 4+/5 on manual muscle testing. He improved his independence with transfers, and improved gait mechanics and balance. His PASS score improved from 6/36 to 34/36 and his FIM score from 44/126 to 92/126 by discharge. Discussion: The physical therapy (PT) interventions that targeted LE strengthening, gait, and balance training were beneficial. This patient’s recovery was affected by his immediate treatment, access to equipment and technology, and having an interdisciplinary team. Further investigation should be conducted in different inpatient rehabilitation facilities, for patients with chronic stroke, and for patients in different PT settings.
Dwyer, Victoria, "Gait, Strength, And Balance Training For A 43-Year-Old Male Following An Acute Right Middle Cerebral Artery Stroke: A Case Report" (2019). Case Report Papers. 113.