Patient Story: David (Stroke)

David suffered a right hemisphere stroke in January 2019, resulting in a craniectomy to relieve the pressure on his brain from the swelling. As a result he was left with very significant left sided weakness, a loss of sensation, severe pain and a lack of awareness of midline. He was unable to move around in bed, gain sitting or standing balance or walk. David had a long period of rehab in linden lodge with the NHS and was discharged in January 2020. At this time there was a wait for outpatient services so they sought private intervention with PWYA. Sadly covid then hit and David has been unable to access any suitable NHS community or outpatient therapy. He has continued with PWYA throughout COVID taking the necessary precautions.

On initial assessment David had very limited independence, he used a shower chair on wheels to sit and move around the house and was only able to take a few steps walking with his wife when she was able to help. The pattern of his walking was very challenging and he was unable to straighten his hemiplegic knee or balance over it. He had pain, spasticity, loss of midline awareness, massive fear of falling and was unable to get up or walk by himself. His arm was rigid by his side and very painful to move with minimal range of passive movement, no active movement was present, bringing more stiffness into his body, blocking his ability to balance and walk better.

David had intensive therapy (3 times a week) and continues to have this. His goals were:

• Gain independence in sit to stand, standing and walking short distances;

• Reduction in pain and spasticity;

• Feel less fear.

Therapy has used releasing soft tissue to gain activity, symmetry and alignment to regain function. It follows the approach of sensory awareness, improving attention into the left side and reducing fear to regain balance.

Today David can stand independently although he remains hesitant. David can walk unaided a short distance indoors, walk up and down stairs and is working on his posture and balance. He is working hard on the pattern to enable his walking to be more efficient and continues to  work on his arm.  David has an increase in passive range and he has some active movement around his shoulder. David has also successfully returned to work.

David at the start of 2021 has set himself a goal to walk 5km around Bestwood woods. He is working today gaining some active reach through his hemiplegic arm. His goals remain to improve efficiency in walking, to walk further and to be able to walk outside independently.