“A stroke weakened her mind, not her will”
A 79 year old elderly patient approached us for Physiotherapy with complaints of not being able to use the right side of her body following a hemorrhagic stroke which she had suffered 2 months back. Further questioning revealed that she had high blood pressure for 5 years and she was not very regular with her medications. Also she had suffered a transient ischemic attack (TIA) one year back which gave her temporary paralysis on the left side of her body but recovered within 24 hours.
Examination revealed constant pain in the paralyzed shoulder; she had a Ryle’s tube for feeding through her nose also a urinary catheter since she was not able to walk upto the toilet. She had no movement of her paralyzed arm and leg and completely depended on her family members for all her daily activities like dressing, moving in bed, grooming etc.
Rehabilitation focussed mainly on:
- 6 sessions per week, duration about 1 hour.
- Pain management for shoulder
- Training her bed mobility activities such as rolling to side lying, side lying to sitting
- Trunk control: sitting and righting within the base of support sideways, front and backwards.
- Activities with Swiss ball for improving lower limb control.
- Balance and training her to walk.
- Progression to stair climbing and descending
The treatment was progressed as and when improvement was noted during therapy. Regular follow-up visits were done for her and her progress was recorded at each interval. By the end of 16 weeks she was able to move her arm without any pain and use it for feeding herself, bathing etc. With respect to her lower limb she was walking with no support, climb stairs with railing support. She also goes out for walks with her friends outside her apartment.
Following are her Chedoke Mc Master Stroke Assessment (CMSA) scores which indicate her remarkable improvement.
|Intervals||Disability Inventory out of total score of 42||Activity Inventory out of total score of 100|
|After 10 weeks||26||60|
|After 16 weeks||39||100|