Intensive Physiotherapy Interventions in Speedy Recovery of Sub-acute Stroke: A Case Series

  • Shambhu P Adhikari Kathmandu University School of Medical Sciences, Dhulikhel, Nepal https://orcid.org/0000-0002-2635-6844
  • Riju Maharjan Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
  • Redisha Jakibanjar Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
  • Anushree Balla Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
  • Manisha Shrestha Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
  • Narendra Shalike Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
  • Govinda M Nepal Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
Keywords: Enriched environment, Intensive physiotherapy intervention, Stroke, Sub-acute

Abstract

Introduction: Intensive physiotherapy interventions have shown good recovery in stroke if applied to stable patients who can tolerate it. Influence of enriched environment on intensive physiotherapy interventions after acute care has not been studied in low-resource contexts, and therefore, we reported outcome of the interventions in multiple cases with stroke in Nepalese context and cultural background. Case reports: Three patients in sub-acute stage of stroke were admitted in intensive physiotherapy treatment unit where the environment was therapeutically enriched. The therapist-administered interventions were intensive for each domain of impairment and activity limitations, every day for six days a week. Patients were trained to carry out caregiver-assisted practice or self-practice in enriched environment. Training demonstrated visible and measurable outcome in all cases. Conclusion: Intensive physiotherapy interventions in an enriched environment promoted good recovery in short period in stroke. The interventions applied, and the principles adopted were based on the established evidence, and therefore findings of this study may support for its feasibility and applicability.

Downloads

Download data is not yet available.

Author Biographies

Shambhu P Adhikari, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal

Assistant Professor,

Department of Physiotherapy.

Riju Maharjan, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal

Physiotherapist,

Department of Physiotherapy.

Redisha Jakibanjar, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal

Physiotherapist,

Department of Physiotherapy.

Anushree Balla, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal

Physiotherapist,

Department of Physiotherapy.

Manisha Shrestha, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal

Physiotherapist,

Department of Physiotherapy.

Narendra Shalike, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal

Lecturer,

Department of Neurosurgery.

Govinda M Nepal, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal

Assistant Professor,

Department of Physiotherapy.

References

Langhorne P, Wu O, Rodgers H, Ashburn A, Bernhardt J. A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial. Health Technol Assess. 2017;21(54):1-120. PMID: 28967376. DOI: https://doi.org/10.3310/hta21540

Rosenbaum AM, Gordon WA, Joannou A, Berman BA. Functional outcomes following post-acute rehabilitation for moderate-to-severe traumatic brain injury. Brain Inj. 2018;32(7):907- 14. PMID: 29738278. DOI: https://doi.org/10.1080/02699052.2018.1469040

Coleman ER, Moudgal R, Lang K, Hyacinth HI, Awosika OO, Kissela BM, et al. Early Rehabilitation After Stroke: a Narrative Review. Curr Atheroscler Rep. 2017;19(12):59. PMID: 29116473. DOI: https://doi.org/10.1007/s11883-017-0686-6

Adhikari SP, Tretriluxana J, Chaiyawat P, Jalayondeja C. Enhanced Upper Extremity Functions with a Single Session of Action- Observation-Execution and Accelerated Skill Acquisition Program in Subacute Stroke. Stroke Res Treat. 2018;2018(0):1490692. PMID: 30009017. DOI: https://doi.org/10.1155/2018/1490692

Bernhardt J, Godecke E, Johnson L, Langhorne P. Early rehabilitation after stroke. Curr Opin Neurol. 2017;30(1):48-54. PMID: 27845945. DOI: https://doi.org/10.1097/wco.0000000000000404

Tijsen LM, Derksen EW, Achterberg WP, Buijck BI. Challenging rehabilitation environment for older patients. Clin Interv Aging. 2019;14(0):1451- 60. PMID: 31496672. DOI: https://doi.org/10.2147/cia.s207863

Xie H, Yu K, Zhou N, Shen X, Tian S, Zhang B, et al. Enriched Environment Elicits Proangiogenic Mechanisms After Focal Cerebral Ischemia. Transl Stroke Res. 2019;10(2):150-9. PMID: 29700717. DOI: https://doi.org/10.1007/s12975-018-0629-8

Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008;51(1):S225-39. PMID: 18230848. DOI:

https://doi.org/10.1044/1092-4388(2008/018)

Winstein CJ, Miller JP, Blanton S, Taub E, Uswatte G, Morris D, et al. Methods for a multisite randomized trial to investigate the effect of constraint-induced movement therapy in improving upper extremity function among adults recovering from a cerebrovascular stroke. Neurorehabil Neural Repair. 2003;17(3):137- 52. PMID: 14503435. DOI: https://doi.org/10.1177/0888439003255511

Ada L, Dean CM, Morris ME, Simpson JM, Katrak P. Randomized trial of treadmill walking with body weight support to establish walking in subacute stroke: the MOBILISE trial. Stroke. 2010;41(6):1237-42. PMID: 20413741. DOI: https://doi.org/10.1161/strokeaha.109.569483

Published
2020-12-25
How to Cite
1.
Adhikari S, Maharjan R, Jakibanjar R, Balla A, Shrestha M, Shalike N, Nepal G. Intensive Physiotherapy Interventions in Speedy Recovery of Sub-acute Stroke: A Case Series. J Lumbini Med Coll [Internet]. 25Dec.2020 [cited 21Jan.2021];8(2):6 pages. Available from: https://jlmc.edu.np/index.php/JLMC/article/view/375
Section
Case Report