RECOVERY OF HAND FUNCTION AFTER STROKE, A HAND REHABILITATION PROGRAMME EXPERIENCE AND PROPOSAL

Background: P.R., a 63 years old male retired doctor, suffered a sudden stroke due to severe (80%) Basilar Artery stenosis that caused a total left hemiplegia at day 2nd after stroke. He had a very active life, he spent his... [ view full abstract ]

Background:
P.R., a 63 years old male retired doctor, suffered a sudden stroke due to severe (80%) Basilar Artery stenosis that caused a total left hemiplegia at day 2nd after stroke. He had a very active life, he spent his time in his country mill doing the garden, in his hometown doing some medical examination, traveling, but especially driving his great passion: a 1943 Willy's MB Jeep.
Theoretical underpinning:
The proposed treatment is based on the reconstruction of cortical image of the hand through guided sensory integration (GSI) in the ADL, proprioception exercises, selective muscles activation requests, (SMAR) free and task orientated, and Graded Motor Imagery (GMI).
Assessment / Intervention/ Technique:
The intervention started in the 2nd day after stroke, and continued each day for about a month. It started with GSI and proprioception exercises, followed by GMI after 7 days while SMAR is graduated following the neurological movements recovery.
Evaluation of outcome:
Range of Motion, Jamar Test, PRWHE, COPM, VAS and Touch Test sensory evaluation have been assessed in 4 different times from the beginning of the treatment to 3 months after stroke.
Application to practice:
This treatment could be performed by any OT to replace or supplement the current hand rehabilitation standard protocol after stroke and could lead to good results as in the case of P.R., who recovered his hand much more than the other parts of affected side and especially returned to drive his Jeep