A Case Report - Physiotherapy Rehabilitation in a Chronic Ataxic Stroke Patient

Abstract

Introduction: The cerebellum is primarily responsible for coordination, balance, and muscle control. Cerebellar
infarction or haemorrhage can lead to an acute onset of cerebellar dysfunction. The dysfunction often leads to ataxia, which
is defined as impaired coordination of voluntary muscle movements.
Case Presentation: A 54-year-old male rickshaw driver presented with difficulties in walking and transferring, as well as
multiple episodes of falling. He also experienced challenges with activities of daily living, such as bathing, dressing, and
eating, following a cerebrovascular accident around 7 years ago.
Intervention: Intervention was given 1.5 hours per day,5 days a week, for 8 weeks. Intervention includes education
sessions, static and dynamic balance training, quasi-mobile task, body weight support treadmill training, stair gait training,
slope walking, transfer activity, and task-specific training.
Outcomes: After the 8 weeks of intervention, the FIM score improved from 83 to 105, the BBS score improved from 26 to
36, and the ISS score increased from 74 to 83. The time taken to complete the 5 Times Sit to Stand Test decreased from 1.26
minutes to 40 seconds, and the number of falls reduced from 3 to 0. Retention of the exercise effect was also seen in followups
(1-2 months).
Conclusion: A tailor-made, goal-oriented physical therapy intervention including education, counselling sessions, and
exercises designed and implemented based on the principles of motor control, motor learning, and neuroplasticity will
provide recovery even in chronic ataxic stroke patients.