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      Impact of Proprioceptive Neuromuscular Facilitation Technique for Early Rehabilitation to Restore Motor Impairments in a Classic Case of Left Middle Cerebral Artery Stroke

      case-report
      Author(s): 1 , , 1 , 1
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: motor impairement, stroke rehabilitation, physiotherapy, proprioceptive neuromuscular facilitation, middle cerebral artery

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          Abstract

          An abrupt hemorrhage or ischemia causes acute onset of stroke. The characteristic feature of hemiplegia is the loss of voluntary movement with the alteration of muscle tone, reflexes, and sensation. In this case, we present a 56-year-old man who suffered from right hemiplegia, facial palsy, and expressive aphasia. The MRI of the brain revealed a hemorrhagic transformation of acute infarct in the left frontoparietal-temporo-occipital lobe. The patient was managed immediately by medical interventions. The physiotherapy treatment was initiated after the stabilization of acute symptoms at an early stage. This case report details the management of the patient with physical therapy and highlights the advantages of exercise therapy, particularly the proprioceptive neuromuscular facilitation technique for enhancing the patient's condition by incorporating physiotherapy protocol from an early stage.

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          Stroke.

          Geoffrey A Donnan, Marc Fisher, Malcolm Macleod … (2008)
          Stroke is the second most common cause of death and major cause of disability worldwide. Because of the ageing population, the burden will increase greatly during the next 20 years, especially in developing countries. Advances have occurred in the prevention and treatment of stroke during the past decade. For patients with acute stroke, management in a stroke care unit, intravenous tissue plasminogen activator within 3 h or aspirin within 48 h of stroke onset, and decompressive surgery for supratentorial malignant hemispheric cerebral infarction are interventions of proven benefit; several other interventions are being assessed. Proven secondary prevention strategies are warfarin for patients with atrial fibrillation, endarterectomy for symptomatic carotid stenosis, antiplatelet agents, and cholesterol reduction. The most important intervention is the management of patients in stroke care units because these provide a framework within which further study might be undertaken. These advances have exposed a worldwide shortage of stroke health-care workers, especially in developing countries.
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            Assessing motor impairment after stroke: a pilot reliability study.

            C Collin, D Wade (1990)
            Two short tests of motor function, the Motricity Index (MI) and the Trunk Control Test (TCT), were assessed at regular intervals after stroke and compared with a detailed physiotherapy test, the Rivermead Motor Assessment (RMA). The MI and TCT were valid and reliable tests which were usually quicker to perform than the RMA. The TCT was of predictive value when related to eventual walking ability. All three tests appeared to be of equal sensitivity in detecting change.
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              Diagnosis of acute stroke.

              Kenneth S Yew, Eric Cheng (2015)
              Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of the diagnosis of ischemic stroke. The most common presenting symptoms of ischemic stroke are speech disturbance and weakness on one-half of the body. The most common conditions that can mimic a stroke are seizure, conversion disorder, migraine headache, and hypoglycemia. Taking a patient history and performing diagnostic studies will usually exclude stroke mimics. Neuroimaging is required to differentiate ischemic stroke from intracerebral hemorrhage, as well as to diagnose entities other than stroke. The choice of neuroimaging depends on availability of the method, the patient's eligibility for thrombolysis, and presence of contraindications. Subarachnoid hemorrhage presents most commonly with sudden onset of a severe headache, and noncontrast head computed tomography is the imaging test of choice. Cerebrospinal fluid inspection for bilirubin is recommended if subarachnoid hemorrhage is suspected in a patient with a normal computed tomography result. Public education about common presenting stroke symptoms may improve patient knowledge and clinical outcomes.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 7 November 2022
                Publication date (Electronic, collection): November 2022
                Volume: 14
                Issue: 11
                Electronic Location Identifier: e31222
                Affiliations
                [1 ] Department of Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
                Author notes
                Article
                DOI: 10.7759/cureus.31222
                PMC ID: 9733788
                SO-VID: d20bfe56-2cdc-4b6c-9405-6b42f5ab9c7a
                Copyright © Copyright © 2022, Kazi et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 30 September 2022
                Date accepted : 7 November 2022
                Categories
                Subject: Neurology
                Subject: Physical Medicine & Rehabilitation
                Subject: Neurosurgery

                Keywords: motor impairement,stroke rehabilitation,physiotherapy,proprioceptive neuromuscular facilitation,middle cerebral artery
                Data availability:
                Keywords: motor impairement, stroke rehabilitation, physiotherapy, proprioceptive neuromuscular facilitation, middle cerebral artery

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