🏥 Case Study: Post-Stroke Rehabilitation in a 62-Year-Old Male
Patient Pro le
Name: Mr. Ahmed
Age: 62
Gender: Male
Diagnosis: Left Hemiparesis secondary to right-sided ischemic stroke
Date of Incident: 4 weeks prior to initial PT evaluation
Referral: Neurologist referral to Physical Therapy for post-stroke rehabilitation
Medical History
Hypertension (10 years)
Type 2 Diabetes Mellitus
Smoker (quit after stroke)
No previous history of stroke or neurological disorders
Subjective Assessment
Chief Complaint: Di culty walking, weakness in the left arm and leg, poor balance
Patient reports fatigue during minor activity and fear of falling
Motivation to return to independent living
Objective Findings
Motor Control:
Left upper limb: 2/5 strength (MRC scale)
Left lower limb: 3/5 strength
Tone: Mild spasticity in left upper limb (Modi ed Ashworth Scale: 1+)
Balance: Unable to maintain single-leg stance, Berg Balance Scale score: 28/56
Gait: Step-to gait pattern with left leg dragging slightly
Sensation: Decreased proprioception in left foot and hand
Functional Limitation: Requires assistance for dressing, grooming, and walking
Treatment Goals
Short-Term Goals (2 weeks):
Improve sitting and standing balance
Increase lower limb strength to 4/5
Walk with minimal supervision for 10 meters
Long-Term Goals (6–8 weeks):
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Independent ambulation with cane
Perform all basic ADLs (Activities of Daily Living) without assistance
Restore con dence and reduce fall risk
Physical Therapy Interventions
Neurofacilitation Techniques:
Proprioceptive Neuromuscular Facilitation (PNF) patterns
Rhythmic initiation for shoulder and hip control
Therapeutic Exercises:
Seated marching and bridging
Step-ups and mini squats
Resistance training with therabands
Balance Training:
Static standing balance on foam
Weight shifting and single-leg support
Gait Training:
Parallel bars initially
Progression to walker and cane use
Verbal and tactile cueing for heel strike
Functional Training:
Sit-to-stand practice
Dressing simulation
Task-speci c reaching and grabbing
Outcome after 6 Weeks
Strength improved: LUE 3+/5, LLE 4+/5
Berg Balance Score increased to 44/56
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Independent with cane for short distances
Performs ADLs independently with mild supervision
Improved con dence and participation in home environment
Conclusion
The case demonstrates the importance of early, structured, and individualized physical therapy in
restoring functional independence following a stroke. Through a combination of
neurorehabilitation techniques, strength and balance training, the patient achieved signi cant
improvement in motor control and quality of life.