Acute Ischemic Stroke
60 year old male who had sudden symptoms of left side weakness. He was previously fit and well. Attended A&E and was diagnosed with an ischemic stroke (blood clot). He spent 6 days in hospital before being discharged home. He lived with his wife in a two storey house.
Presenting problems:
- Reliance on the bannister to go up and down the stairs.
- Reduced walking speed and reduced confidence in mobility.
- Supervision required to walk outdoors as he was feeling unbalanced and unconfident.
- Supervision to get in and out of the shower and/or bath.
Assessment:
- Post stroke fatigue.
- Slightly reduced muscle power through left arm and leg.
- Reduced high level balance.
- Reduced confidence.
- Confusion about what exercise he should be completing following his stroke.
Treatment:
- Education regarding exercise post stroke and fatigue management.
- Home exercise plan consisting of strengthening, coordination, stretching and functional movements.
- Attended a 6 week block in physiotherapy led balance classes.
Outcomes:
- Time up and go outcome measure (sit to stand, walk 3 metres and sit back down)- improved from 16 seconds to 13 seconds seconds to
- Berg Balance Scale outcome measure increased from 50/56 to 56/56.
- Patient reported recovery from 85%-100%.
- Safe and independent with outdoor mobility.
- Safe and independent with all functional tasks.
- Returned to work full time.