Related Case Studies
Case Study of Stroke: Assisting a 62-year-old to live independently after Physical Therapy
Patient Information
Age: 62
Sex: Female
Patient Profile: Retired school teacher belongs to a semi-urban neighbourhood and stays with her husband and adult son, who is a student. Generally physically active, but has a medical history with mild hyper.
What Was the Cause of the Stroke
Patient experienced weakness on her right side of the body with slurred speech. She was immediately rushed to the hospital. The CT scan revealed an ischemic stroke in the left side of the brain caused by blockage of blood vessels. Her high blood pressure, which was not under control, was the cause of the attack.
She had been given the antihypertensive medication, but she had not taken it during the last few months. With no realisation, she was tired and weak for weeks before the incident, and she attributed it to being old.
Assessment
Initial Diagnosis:
- Left hemispheric ischemic stroke
- Right-sided hemiparesis (partial paralysis)
- Mild expressive aphasia (difficulty speaking clearly)
- Left hemiparesis from ischemic stroke
- Mild expressive aphasia makes it difficult to speak clearly
- Right hemispheric ischemic stroke
Assessment Process:
The hospital's multi-disciplinary team undertook the following:
- A CT scan and later an MRI confirmed the location and extent of the stroke.
- A physiotherapist assessed muscle strength, limb coordination, and mobility.
- A speech therapist assessed the severity of the speech impairment.
- An occupational therapist assessed the individual's ability to perform activities of daily living.
Diagnosis: She was given an NIH Stroke Scale score of 10, indicating a moderate stroke.
Treatment
- Plan of Action:
Following stabilisation, the patient was relocated to a specialised stroke rehab unit. The main goal is to regain her strength, balance and independence through intensive physical rehabilitation and progressive programs.
Program
Phase 1: Immediate Rehabilitation (Week 1–3)
- ROM exercises are done for the right upper and lower limbs
- Used a therapist technique for sit-to-stand with a walker
- Breathing exercises and some conditioning,
- Mirror therapy to activate the connection between the brain
Phase 2: Early Mobilisation (Week 4–6)
- Active-assistive exercises вала
- Balance exercises with a Therapy ball
- Gait training with a walker
- Speech therapy 2 times per week
- Practice "Activities of Daily Living" -- brushing teeth, feeding oneself
Phase 3: Strength and Endurance Phase (Week 7–10)
- Resistance exercises to lower extremities
- Stairs and outdoor ambulation
- Endurance activities such as stationary cycling
- Functional mobility activities such as folding laundry, going upstairs
- Speech and occupational therapy continue robustly
Medical Treatments:
- Aspirin (75 mg daily) helps in the prevention of strokes
- Statins manage cholesterol
- Blood pressure medications were adjusted for optimal control
- Muscle relaxants were used for right arm stiffness as needed
Therapy Sessions Conducted:
- Physical Therapy: Daily, focused mainly on mobility, strength, and eventually walking
- Occupational Therapy: Re-learning all tasks of daily living
- Speech Therapy: Language building exercises and practice pronunciation
- Family Counselling: Orientation sessions on stroke care, safety, and emotional support
Improvements / Timeline of Recovery
Week 1-2:
- Began passive exercises; patients required full support to sit or move. The right limbs were completely immobile; some minor facial asymmetry was noted.
Week 3-4:
- Began assisted sitting and standing, first steps with a walker while being supervised. Slight improvements in shoulder and elbow movement.
Week 5-6:
- Able to walk 10-20 steps with a walker. Made some short (4-5 words), clear sentences with help from the speech therapist. Reached for the arm during therapy (the right arm).
Week 7-8:
- Able to walk 50+m with a cane. Independent with feeding, bathing and dressing. Completed household tasks with supervision.
Week 9-10:
- Able to climb stairs slowly with the help of the railing. Did some light gardening. Tutored my kids. Reached 80% of the ability and function I had pre-stroke.
Our Accomplishment: Impact on Patients' Lives
By the conclusion of the Jagruti Rehab Centre 10-week program, the patient had achieved almost complete independence in her daily activities. She could walk without assistance within the house and utilised a cane when walking outside. Communication improved dramatically, and her self-confidence was reinstated. She no longer needed 24-hour assistance and resumed all former activities and interests, including gardening and reading.
Impact on Her Family and Community
The family engagement had an undoubtedly positive impact on her recovery. Both her husband and son attended therapy and gained a good understanding of what sort of assistance was necessary to navigate rehabilitation exercises. Thus, the emotional burden for the family was lessened, and the timeframe of healing could occur sooner.
There was also an impact directly on her community.
Her recovery sparked an interest among other seniors in checking their blood pressure regularly and having a better understanding of stroke symptoms. The Jagruti Rehab Centre that worked with her received more questions and requests from other families seeking early intervention in rehabilitation, along with many individuals calling in to get control of their health after considering her case.
Lessons Learned And Expert Recommendations
This case demonstrates how strengthening physical therapy can improve a stroke patient’s outcome. We do not recover solely from medication; recovery involves emotional support for the patient with encouragement and motivation, reestablished mobility, patient-designated rehabilitation approach, and a reestablished sense of self after loss of mobility.
What We Learned:
- Early exercises, no matter how menial, allowed for fewer complications in a patient.
- Family may support, improve morale, and provide consistency in caregiving
- Recognising value in small progress creates real progress
- Low-priced/low-cost therapy items can provide meaningful therapy at home (e.g walker, therapy balls)
Expert Opinion:
Rehabilitation should start within 48-72 hours of stroke stabilisation. Meaning that the patient begins engaging in exercises appropriate for their ability (for example, only doing assisted leg movements or the transfer from the bed to chair), improving a stroke patient's outcome by reducing the chance of stiffness or muscle wasting.
Caregiver Note:
Encouragement was the most fundamental source of motivation in our experience with the patient. Each little effort is a step forward, and honestly, it can be one powerful encouragement to the stroke patient to make it one step every day toward recovery following the disruption to life after a stroke.
Bottom Line
This case study on stroke rehabilitation does show how a patient can regain mobility, capacity, and confidence, with timely intervention and a focused plan for rehabilitation. Restoration is seldom the same as prior states of function, but does often show progress. With sufficient and right care, a stroke survivor can walk and talk and live a valuable life even if they are in their sixties.
Dr. Amar Shinde, founder of Jagruti Rehab, is a renowned psychiatrist in India with over two decades of experience in mental health, addiction recovery, and neuropsychiatry, dedicated to holistic, compassionate patient care.