“Cerebrovascular accident (CVA) is the medical term for what is commonly termed a stroke. It refers to the injury to the brain that occurs when flow of blood to brain tissue is interrupted by a clogged or ruptured artery, causing brain tissue to die because of lack of nutrients and oxygen.” –http://healthtools.aarp.org/galecontent/cerebrovascular-accident
We are used to treating elderly patients with this condition: however, in 2006, we had a 34 year old resident admitted from the hospital to our facility, whose primary medical diagnosis was a “severe” CVA. He was dependent in all aspects of self-care and functional mobility.
This resident, despite his current condition, was very upbeat. He received Occupational, Physical, and Speech therapies. After approximately 6 months of therapy, the resident was able to walk with a cane and transfer with supervision. His treatment regimen for Physical Therapy entailed: 1) Active and active-assistive range-of-motion exercises, strengthening exercises, neuromuscular re-education, physical agent modalities, and use of an Omnicycle. These modalities were used to promote strength in both lower extremities. We also worked on standing tolerance and balance, which were instrumental in progressing him toward functional ambulation.
We started with a front wheeled walker with a forearm attachment to begin gait training. We trialed using a quad cane, but his balance was not good enough to advance safely. Eventually, he became strong enough to use a standard cane; however, we opted to implement the front wheeled walker when he had sufficient return in his affected upper extremity for increased safety and stability.
Despite the excellent progress, high motivation, and positive attitude, he is still living at the nursing home because he is unsafe to live at home alone. Even though the resident is not on therapy anymore, he works daily on his own functional maintenance program and keeps me up to date on his progress. He enjoys living at this facility, maintains his positive attitude, and hopes someday that a return home will be possible.
This resident has written several letters to the editor of the local newspaper
discussing his progress and how pleased that he and his family are with the center and rehabilitation staff.