Stroke is the 5th leading cause of death in America and one of the most expensive management diseases that are seen in emergency departments throughout the United States.1 There are several risk factors predisposing an individual to stroke such as smoking, leading a sedentary lifestyle, increased stress, diabetes, or genetics.1,2,3 Following a cerebrovascular accident, there are several long term effects consisting of: decreased strength, decreased force production, decreased endurance, decreased function, and decreased gait speed contributing to the patient’s difficulty performing everyday activities or community ambulation.2 Following the stroke, the hemiparetic limb shows significantly impaired muscular strength as compared to the non-hemiparetic
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He is hispanic but understands and speaks English as his second language. Upon the subjective history interview, the patient expressed he has seen no improvements with past physical therapy and has gotten to a point where he just feels it will never get better. He came to us for low back pain, however throughout the history his main complaint was difficulty with balance and walking. There signs/symptoms of depression in his negative mood towards his condition as well as his frustration when he was not understood due to dysarthria. Lumbar spine was 50% limited in all motions, left lower extremity passive range of motion had spasticity at an Ashworth scale grading of 1+ meaning there was slight increase in tone followed by a catch that was continued throughout the rest of the range.10 Bohannon and Smith10 determined that the Modified Ashworth Scale is of approximately 87% agreeance between two clinicians, however it is reported more studies should be utilized. Lower extremity active range of motion was limited due to weakness and spasticity of the left lower extremity. Patient was a 4-/5 generally on the right lower extremity, and a 2+/5 on the left lower extremity with the inability to perform the majority of tests. Patient reported pain with hamstring length tests and was approximately 45* on the left with a straight leg raise and …show more content…
Stroke is one of the most common reasons for hospital visits in the United States, as well as one of the main reasons for prolonged extremity impairments decreasing quality of life.1,2,3,4 Prior studies have reported the effectiveness of strength training, imaging training, balance training, and treadmill training.5,6,7,8,9 However, no study was found to express the improvements secondary to reciprocal stairs training on a standard flight of stairs. It is important for clinicians and therapists to assess the patient goals and function within the community before executing a therapeutic program because patients poststroke have severe losses in functionality especially with sensation and somatosensory functions, contributing to decreased confidence and ability to perform community ambulation.21 The patient was initially seen for the first 3 treatments for low back pain, and continued to be treated for low back pain with an addition of left sided hemiparesis on the fourth visit. There were significant gains in strength, decreased pain, and functional gains throughout treatment. The practice of physical therapy in improving quality of life and function in patients poststroke was significant for meaningful change to the
He is hispanic but understands and speaks English as his second language. Upon the subjective history interview, the patient expressed he has seen no improvements with past physical therapy and has gotten to a point where he just feels it will never get better. He came to us for low back pain, however throughout the history his main complaint was difficulty with balance and walking. There signs/symptoms of depression in his negative mood towards his condition as well as his frustration when he was not understood due to dysarthria. Lumbar spine was 50% limited in all motions, left lower extremity passive range of motion had spasticity at an Ashworth scale grading of 1+ meaning there was slight increase in tone followed by a catch that was continued throughout the rest of the range.10 Bohannon and Smith10 determined that the Modified Ashworth Scale is of approximately 87% agreeance between two clinicians, however it is reported more studies should be utilized. Lower extremity active range of motion was limited due to weakness and spasticity of the left lower extremity. Patient was a 4-/5 generally on the right lower extremity, and a 2+/5 on the left lower extremity with the inability to perform the majority of tests. Patient reported pain with hamstring length tests and was approximately 45* on the left with a straight leg raise and …show more content…
Stroke is one of the most common reasons for hospital visits in the United States, as well as one of the main reasons for prolonged extremity impairments decreasing quality of life.1,2,3,4 Prior studies have reported the effectiveness of strength training, imaging training, balance training, and treadmill training.5,6,7,8,9 However, no study was found to express the improvements secondary to reciprocal stairs training on a standard flight of stairs. It is important for clinicians and therapists to assess the patient goals and function within the community before executing a therapeutic program because patients poststroke have severe losses in functionality especially with sensation and somatosensory functions, contributing to decreased confidence and ability to perform community ambulation.21 The patient was initially seen for the first 3 treatments for low back pain, and continued to be treated for low back pain with an addition of left sided hemiparesis on the fourth visit. There were significant gains in strength, decreased pain, and functional gains throughout treatment. The practice of physical therapy in improving quality of life and function in patients poststroke was significant for meaningful change to the