Novelty in Exercise Regimen towards Bilateral Training in a Patient after a Cerebrovascular Event
Dr. Pallavi Lalchand Harjpal,
Postgraduate Student, Department of Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Sawangi, Meghe, Wardha, Maharashtra, India.
Ischaemic stroke is caused by a sudden decrease in blood flow to the areas of the brain that leads to severe impairment if left untreated. The impairments include contralateral loss of motor and sensory functions, along with affection on the ipsilateral side. There is a reduction in strength on the unaffected side of stroke, due to the fact that only 75-90% of corticospinal fibres cross from the medulla to the contralateral side. A 45-year-old male, factory owner came with a chief complaint of sudden onset of weakness on the left side of the body for 11 days with a history of hypertension. Investigations revealed a large block in the right Middle Cerebral Artery (MCA). Medical management was provided with thrombolytics, anticoagulants, and antihypertensives. Thereafter, the patient was referred for physiotherapy. Physiotherapy assessment revealed left hemiplegia with more affection of upper extremity, spasticity grade 1+. He also had reduced gripping and grasping. A tailor-made protocol was formulated which focused on task and approach-oriented training with bimanual activities along with consideration of the less affected side was provided to the patient helped in early recovery and made him go back to his occupation. There are many studies on hand rehabilitation, but this is one in its kind that will add to the available literature on the positive effects of strength training on the unaffected side to be considered in rehabilitation.