© 2020 Marisa Flores
Background and Purpose: Although cerebrovascular accidents (CVAs), or strokes, occur often in the United States, only 7% of those strokes affect the pons, an area of the brainstem that provides life-sustaining functions. Due to the rarity of pontine strokes, there is insufficient evidence supporting successful interventions that yield functional benefits for patients admitted to inpatient rehabilitation units (IRU). The purpose of this case report was to examine gait, balance and functional mobility interventions on the restoration of mobility and functional independence of a patient within an IRU.
Case Description: The patient was a 75-year-old female 3 days status post a pontine stroke who was admitted into the IRU to improve independence and functional mobility after presenting with dysphagia, right-sided weakness and impaired functional mobility. Her plan of care included lower extremity (LE) strengthening, gait training with and without body-weight support, balance training and functional transfer training. Outcome measures used were the Five Times Sit to Stand (5xSTS), 10-Meter Walk Test (10MWT), Functional Gait Assessment (FGA), Inpatient Rehabilitation Unit-Performance Assessment Inventory (IRU-PAI), manual muscle testing (MMT), sensation and coordination testing.
Outcomes: The patient improved right LE strength averaging 4/5, increased gait speed from 0.13 m/s to 0.4 m/s on the 10MWT, improved functional transfers from minimal contact assistance to supervision and improved ambulation from 35 feet to 350 feet without an assistive device and a contact guard assist by time of discharge.
Discussion: LE strengthening, balance, gait training and transfer training were beneficial for restoring functional mobility in this patient with subacute pontine stroke. Further research should be performed to assess interventions for patients of varying demographics and stroke types within IRUs.
Flores, Marisa, "Inpatient Rehabilitation For A 75-Year-Old Female Following A Left-Sided Pontine Infarct: A Case Report" (2020). Case Report Papers. 127.