Haemorrhagic stroke
39 year old woman who had a collapse at home following headache and generally feeling unwell. She was previously fit and well and working full time. She was rushed to hospital and was found to have had a Subarachnoid haemorrhage due to an Arteriovenous Malformation (AVM). 2 very young children and she was unable to care for them by herself for periods in the day.
Presenting problems:
- Unable to get on and off the floor without some assistance
- Weakness and increased tone through the right arm and leg.
- Walking with a stick in the house and unable to walk outdoors due to balance
- Unable to stand up from low sofa without assistance
- Right ankle rolling over and swelling after walking in house
Assessment:
- Weakness and spasticity affecting ability to walk and to use arm for tasks such as doing up zips, buttons or writing
- Weakness through core, trunk, leg and arm.
- Reduced balance due to decreased weight bearing through leg and instability around ankle
Treatment:
- Long rehabilitation journey over 2.5 years. Starting with blocks of weekly Physiotherapy sessions, fortnightly, monthly to finally “check-in” sessions when she feels that she needs them
- Collaborative work with orthotics provision, wheelchair services, botox clinic consultant liaison, Functional Electrical Stimulation assessment.
- Soft tissue work, stretches and strengthening. Worked in an adapted gym and then a mainstream gym for strength and conditioning.
Outcomes:
- Attends clinic Pilates class once a week for maintenance
- Working part time for a Stroke charity
- Fully independent around the house and looking after her children (with some adaptations)
- Able to use arm for functioning including writing with it
- Berg Balance from 33/56 to 48/56
- Sit to stands in 30 seconds from 4 to 10
