Physiotherapy Rehabilitation in Cerebellar Stroke: A Case Study

Abstract

Cerebellar stroke presents a challenging task for rehabilitation. The patient in this case study was a 61-year-old man with a diagnosis of posterior circulation ischaemic stroke. He was referred to our physiotherapy outpatient unit in a major tertiary hospital in Nigeria about two years ago. Patient could not sit up from lying, nor stand or walk independently. Visible and palpable tremors were observed in the entire body but more pronounced in the head, neck and shoulders (titubation). Patient could not perform self-care activities; there was difficulty with speech, language and communication. The treatment included free active exercises, mat exercises, bridging, rolling and sitting and standing balance training, breathing exercises, bicycling, walking within parallel bars, wobble board, facial massage, strengthening exercises, cervical collar use and home programme. Involved repetition of treatment session activities taught to his caregivers who were ascertained competent to effect. Treatment was structured into short term and long term goals. Treatment sessions were initially given twice daily, then once weekly and later once monthly, as the patient gained control, confidence and independence. After 68 sessions of treatment spanning almost 2 years, the patient had gained independent walking, improved quality of life, and in particular titubation disappeared.