Effects of Bobath and Neurodevelopmental Treatment in A 3.5 Years Old Child with Lacunar Pure Motor Stroke Following Ventricular Septal Defect Repair
Bobath and Neurodevelopmental Treatment in A Child with Lacunar Pure Motor Stroke
DOI:
https://doi.org/10.54393/pjhs.v3i05.233Keywords:
Lacunar stroke, lacunar infarct, bobath therapy, neurodevelopment therapy, motor strokeAbstract
Lacunar pure motor stroke happens when an artery leading to the deep section of the brain, which contains the organs like the thalamus or basal ganglia is obstructed. Small and occurring outside of the cortex, lacunar strokes are a subtype of ischemic stroke. Lacunar strokes mostly affect patient’s memory, judgmental skills and language. On the basis of symptoms, lacunar stroke is categorized as pure motor hemiparesis (45% cases), pure sensory stroke (7% cases) and ataxic hemiparesis (17-18% cases). We reported a case of 3.5 years old male patient with pure motor lacunar stroke following ventricular septal defect repair who was effectively treated with bobath therapy and neurodevelopmental therapy as bobath is a generally accepted theory in the rehabilitation of hemiparetic stroke victims worldwide. On examination, the patient had a total pure motor based right sided hemiparesis. The lower extremity movements were more compromised than upper extremity, strength of mainly antigravity or postural muscles was compromised and lower extremity muscles were scoring 1/5 on Manual Muscle Testing (MMT) and scored 1 on Modified Ashworth Scale (MAS). As such there was no spasticity factor in the upper or lower limb muscles but there was weakness (right sided hemiparesis), so the treatment plan was given and thoroughly explained to the patient’s caretaker. There was no major cognitive and sensory deficit, as lacunar stroke has a better prognosis than other types of stroke, so, the recovery was good within 3 to 4 months by NDT and bobath therapy. Bobath therapy mainly improves the motor function with postural balance and stability.
References
Berberich A, Schneider C, Herweh C, Hielscher T, Reiff T, Bendszus M, et al. Risk factors associated with progressive lacunar strokes and benefit from dual antiplatelet therapy. European Journal of Neurology. 2020 May; 27(5):817-824. doi: 10.1111/ene.14159.
Bashir S, Terceño M, Buxó M, Silva Y, Álvarez-Cienfuegos J, Vera-Monge V, et al. Progressive Lacunar Strokes: A Predictive Score. Journal of Stroke & Cerebrovascular Diseases. 2022 Aug; 31(8):106510. doi: 10.1016/j.jstrokecerebrovasdis.2022.106510.
Guzik A and Bushnell C. Stroke Epidemiology and Risk Factor Management. Continuum (Minneap Minn). 2017 Feb; 23(1, Cerebrovascular Disease):15-39. doi: 10.1212/CON.0000000000000416.
Gore M, Bansal K, Asuncion RM. Lacunar Stroke 2020.
Gorelick PB. The global burden of stroke: persistent and disabling. Lancet Neurology. 2019 May; 18(5):417-418. doi: 10.1016/S1474-4422(19)30030-4.
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017 Sep; 390(10100):1211-1259. doi: 10.1016/S0140-6736(17)32154-2.
Katan M and Luft A. Global Burden of Stroke. Seminars in Neurology. 2018 Apr;38(2):208-211. doi: 10.1055/s-0038-1649503.
Nair R, Gandeti R, Chatterjee A, Chandran V, Gorthi SP, Puppala G, et al. Clinical, radiological and risk factor profiles of acute lacunar stroke in a developing country. Neurology Asia. 2021 Mar; 26(1).
Clavier I, Hommel M, Besson G, Noèlle B, Perret JE. Long-term prognosis of symptomatic lacunar infarcts. A hospital-based study. Stroke. 1994 Oct; 25(10):2005-9. doi: 10.1161/01.str.25.10.2005.
Pathak A, Gyanpuri V, Dev P, Dhiman NR. The Bobath Concept (NDT) as rehabilitation in stroke patients: A systematic review. Journal of Family Medicine and Primary Care. 2021 Nov; 10(11):3983-3990. doi: 10.4103/jfmpc.jfmpc_528_21
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are 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. For comments