Physiotherapy Management of Left Hemiparesis Following Non-Hemorrhagic Stroke: A Case Report

Ni Putu Ayu Cintya Lestari Diani; Pande Putu Ayu Novita Dewantari; I Gusti Ngurah Tri Danu Artha; Gede Agus Airlangga; Luh Putu Ayu Vitalisyawati; Ni Putu Dwi Larashati; I Made Aditya Prawira Arthawan; I Komang Suciptha Gago; I Made Agus Artha Winangun

doi:10.24843/

Authors

Ni Putu Ayu Cintya Lestari Diani Physiotherapy Professional Education Study Program, Faculty of Medicine, Dhyana Pura University, Badung, Bali, Indonesia Author
Pande Putu Ayu Novita Dewantari Physiotherapy Professional Education Study Program, Faculty of Medicine, Dhyana Pura University, Badung, Bali, Indonesia Author
I Gusti Ngurah Tri Danu Artha Universitas Dhyana Pura Author
Gede Agus Airlangga Physiotherapy Professional Education Study Program, Faculty of Medicine, Dhyana Pura University, Badung, Bali, Indonesia Author
Luh Putu Ayu Vitalisyawati Physiotherapy Professional Education Study Program, Faculty of Medicine, Dhyana Pura University, Badung, Bali, Indonesia Author
Ni Putu Dwi Larashati Physiotherapy Professional Education Study Program, Faculty of Medicine, Dhyana Pura University, Badung, Bali, Indonesia Author
I Made Aditya Prawira Arthawan Physiotherapy Professional Education Study Program, Faculty of Medicine, Dhyana Pura University, Badung, Bali, Indonesia Author
I Komang Suciptha Gago Physiotherapy Professional Education Study Program, Faculty of Medicine, Dhyana Pura University, Badung, Bali, Indonesia Author
I Made Agus Artha Winangun Physiotherapy Professional Education Study Program, Faculty of Medicine, Dhyana Pura University, Badung, Bali, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Stroke, Hemiplegia, Physical Therapy Modalities, Activities of Daily Living, Postural Balance

Abstract

Background: Non-hemorrhagic stroke commonly causes hemiparesis, balance impairment, gait dysfunction, and reduced functional independence. Detailed reports of individualized multimodal physiotherapy in routine clinical practice remain limited.
Objective: To describe the clinical outcomes of an individualized physiotherapy program in a patient with left hemiparesis following non-hemorrhagic stroke.
Methods: A CARE-compliant case report was conducted in a 59-year-old man approximately two months after stroke onset. The patient presented with left hemiparesis, muscle weakness, gait dysfunction, and impaired dynamic balance. A five-session individualized program included infrared therapy, active-assisted and resisted exercises, proprioceptive neuromuscular facilitation, heel slides, bridging, education, and a home exercise program. Outcomes were assessed using Manual Muscle Testing, the Five Times Sit-to-Stand Test, and the Barthel Index.
Results: Quadriceps strength improved from grade 3 to 4 and tibialis anterior strength from grade 2 to 3. Five Times Sit-to-Stand performance improved from 13 to 11 seconds, and the Barthel Index increased from 90 to 95. Ambulation progressed from tripod-assisted to independent walking.
Conclusion: Individualized multimodal physiotherapy was associated with short-term improvements in muscle strength, balance, walking ability, and functional independence in this patient. These findings are limited to a single case and require confirmation in larger prospective studies.