Mobility and Gait Outcomes Following Intensive Rehabilitation, Onabotulinumtoxin A, and Baclofen Treatment Chronic Post-Stroke: A Case Report

PURPOSE. This case report describes the effects of intensive rehabilitation with systemic antispasticity and local neurotoxin pharmacological interventions on gait and activity outcomes for a patient with chronic impairments post-stroke. CASE DESCRIPTION. The 56-year-old male patient was 13 months p...

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Bibliographic Details
Published in:Journal of allied health 2014-12, Vol.43 (4), p.229-234
Main Authors: Barakatt, Edward, Coleman-Salgado, Bryan, McKeough, Michael, Mandeville, David, Gong, Jillian, Mintz, Emily, Thatch, Joshua, Vourakis, Anastasia, Thakur, Nicklesh
Format: Article
Language:English
Subjects:
Anatomy
Ankle
Case reports
Exercise
Gait
Hypertension
Kinematics
Males
Mobility
Motion
Patients
Pharmacology
Physical therapy
Range of motion
Rehabilitation
Rehabilitation Programs
RESEARCH ARTICLE
Seizures
Spasticity
Speech Therapy
Stroke
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Summary:PURPOSE. This case report describes the effects of intensive rehabilitation with systemic antispasticity and local neurotoxin pharmacological interventions on gait and activity outcomes for a patient with chronic impairments post-stroke. CASE DESCRIPTION. The 56-year-old male patient was 13 months post-stroke with left hemiparesis and hypertonicity in the left upper and lower extremities. The patient received oral baclofen for widespread hypertonicity and intramuscular onabotulinumtoxinA injections in muscles of the left upper and lower extremities to target local areas of hypertonicity. The patient received weight-supported treadmill training, over-ground gait training, neuromuscular re-education, and balance training three times per week during 20 of the 25 weeks of the study period. OUTCOMES. The patient demonstrated improvements in balance (Berg Balance Scale), mobility (Timed Up and Go test), and motor function (Stroke Rehabilitation Assessment of Movement Measure). Kinematic measures of gait also improved in ankle and knee range of motion during both stance and swing phases. DISCUSSION. This case demonstrates that improvements in impairment and activity outcomes can occur in an individual with significant post-stroke chronic impairments after receiving intensive physical therapy in conjunction with pharmacologic interventions to control hypertonicity. The persistence and generalizability of these results need to be determined.
ISSN:0090-7421
1945-404X