Physical therapy in a patient with viral -encephalitis hemi-paresis: A Case report

Abstract

The purpose of the rehabilitation program is to improve motor skills, coordination, sensory system, mobilization and other existing disorders to achieve activity of daily living (ADL). Physical therapy as part of the multidisciplinary approach can provide core stability exercises, muscular facilitation and stimulation of motion of the upper and lower extremities, balance exercises and mobility exercises, as well as strengthening exercises with PNF facilitation and active stimulation techniques and using the patient's body weight as a training burden. Bobath approach and facilitation exercise can reduce spasticity by strengthening the antagonist muscles. MMT right upper extremity 3/5, left upper extremity 4/5, right lower extremity 2/5, and left lower extremity 3/5. Ashworth scale right upper extremity 1/4, right lower extremity 2/4, and left lower extremity 1/4. Clonus is reduced, the patient can stand with maximum support without clonus for 10 minutes. Trunk impairment scale 12/23 and Barthel index 65/100. Anthropometric examination showed differences in the circumference of the lower extremities, namely the right patella circumference 34-32 cm left, right upper leg 39 cm-left 37 cm, and left lower leg 29-24 cm. Mobilize the patient to a laying position with minimal assistance. Mobilization of the patient is being able to sit with minimal assistance, namely stabilization in the pelvis, sitting to standing with moderate support, which is supported at the knee bilaterally, and standing with support at the knee and pelvic for 10 minutes. This case report concludes that although physiotherapy is done late with strengthening exercise and core stability strengthening techniques, lying down strengthening exercise, it can improve motor skills, coordination, which in turn will increase the patient's independence in carrying out functional activities and ADLs.