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Modulation of stroke-related impairment with physiotherapeutic intervention: A case report of right-side hemiparesis in a diabetic patient with first treatment in an herbal home
Patrick Ayi Ewah * 1, Peter Agba Awhen1 , Idoo Womboh2 , Felicia Agbor-Obun Dan1
1- University of Calabar
2- University of Medical Sciences
Abstract:   (82 Views)
Objectives: Erroneous perception and belief about the cause of stroke may negatively impact survival during and after stroke occurrence. Patient health decisions may be influence by factors such as advice, previous experience, beliefs, and online information. Some patients of African descent believe that stroke is caused by witchcraft and that its related impairments can be permanently ameliorated by divination. Amidst this belief seeking medical intervention is seen as a waste of resources and time making it difficult for health professional to offer adequate care.  The purpose of this study was to explore the importance of patient education combined with physiotherapy intervention in the modulation of stroke-related impairment amid erroneous beliefs about the incidence and management of stroke.
Methods: This is a case of a 63-year-old Nigerian female, a known diabetic, and hypertensive stroke survivor with a complaint of inability to walk, weakness of muscle, and loss of functional movement in her right hand and leg 1 year ago. She underwent 8 weeks of individualized home physiotherapy such as PMRE, TENS, EMS, TOCT, PNF, task-specific training, and gait/balance exercise, in addition, to the use of routine drugs and diet 3 days/week, 2 hours daily using discrete practice. 
Results: There was an improvement in muscle strength, hand functional abilities, gait/balance, ADL, and a reduction in spasticity, glucose level, body adiposity (%BF/VF/BMI), blood pressure/derived cardiovascular indices as per post-intervention scores.

Conclusions: Many factors could influence the patient decision and continuous education of the patient and informal caregivers may positively influence the patient's condition and ameliorates erroneous believes among stroke survivors. We also provide evidence to corroborate and strengthen existing evidence that stroke-related impairments, can be modulated with physiotherapy intervention. We recommend that physiotherapists should include intervention targeted at increasing muscle mass and reducing body fat when treating stroke survivors to ameliorate the negative impact of stroke on the musculoskeletal structure, stroke recurrence, and enhancement of   functional performance in ADL.
Keywords: Wrong perception and belief, stroke-related impairment, progressive manual resistance exercise, task-oriented circuit training, individualized home physiotherapy
     
Article type: Case Reports | Subject: Neurorehabilitation
Received: 2023/04/14 | Accepted: 2023/11/25
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