Date of Award

5-2021

Document Type

Thesis

First Advisor

Gary Schindler

Keywords

Left medullary stroke, acute rehabilitation setting, complex medical history, right body range of motion, neuro re-education, functional electrical stimulation, bed mobility training, transfer training, right upper extremity protection

Abstract

Background and Purpose. Approximately 800,000 strokes occur each year in the United States, either resulting in death or mild to moderate functional deficits. This case study examines the effectiveness of physical therapy treatment of a patient following a left medullary stroke in the acute rehabilitation setting.

Case Description. The patient was a 72-year-old male with a complex medical history who presented to the acute rehabilitation unit with right-sided weakness, diminished postural control, impaired muscle tone, and paresthesia. His admission was complicated by the onset of delirium during the second week of treatment.

Intervention. Physical therapy treatment provided to the patient addressed his functional impairments and activity limitations. Documented interventions included the following: right body range of motion, neuro re-education, functional electrical stimulation, bed mobility training, transfer training, right upper extremity protection & preventative care, therapeutic exercise, and patient education.

Outcomes. Following physical therapy intervention, the patient improved in right body and trunk motor control and increased his independence with bed mobility and transfers. However, due to his slow progress the patient was discharged prior to meeting all set goals.

Discussion. Despite slow progress, the patient responded favorably to treatment. More research needs to be done on the effects of delirium on stroke rehabilitation prognosis and interventions that promote optimal motor function recovery

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