When life throws a hardball : a case study on the effects of delayed rehabilitation on a stroke patient

Date of Completion

1997

Document Type

Thesis

Degree Name

Bachelor of Science in Physical Therapy

Keywords

Stroke, Rehabilitation

Abstract

In clinical practice, it has been observed that patients with impairment that lead to disability and handicap undergo rehabilitation medicine only when secondary complications have occurred. Such is the case of C.D., a 72 year old non-diabetic, hypertensive, male patient diagnosed to have right cerebrovascular accident with left hemiplegia and suffering the dreaded complications of the said disease. The group conducted a 2 month home service treatment to determine the importance of rehabilitation in preventing further complications. The patient was given sets of exercises, given the frequency, repetitions as well as their precautions. For home based rehabilitation, we have considered several factors such as (a) motivation - if the patient would be motivated enough to do the exercises at least 3-5 times a week. (b) proper monitoring of vital signs - considering the age of this patient, low level of endurance, presence of hypertension the family lack the expertise in determining whether to stop or start the exercise again. During the course of two months, the patient have learned to perform the conditioning exercise on right R upper extremity (UE) as well as the active range of motion exercise on R lower extremity (LE) and passive range of motion exercise - active assistive range of motion exercise (PROME-AAROME) on (L) UE and LE on his own with the patient and family well educated on proper exercise precautions. The family and the therapist noted patient and family well educated on proper exercise precautions. The family and the therapist noted patient's increase in motivation and decrease in depression concerning his condition. There is also noted increase in sitting balance from fair to good, sitting tolerance remained good, standing tolerance from poor to fair and standing balance remained fair. Concerning dependence in activities of daily living (ADL's), the patient can transfer and walk within the home area with one moderate assist and perform upper garment dressing independently. In gait training, the patient requires to develop more on his standing balance and tolerance as well as develop his confidence. Recommendations and encouragement have been made to patient and his family to continue rehabilitation in the center to reinforce the progress that has already been attained so as to prevent further complications. For reasons that the patient would not be able to come in the center, he can still do the exercise at home.

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