Inpatient Physiotherapy Management of Quadriparesis Following Ischemic Stroke: A Case Report

Abstract

Background: Ischemic stroke can cause severe motor impairment, including quadriparesis, with substantial limitations in mobility and activities of daily living. Reports of individualized physiotherapy management in patients with severe poststroke impairment remain limited.
Objective: To describe the physiotherapy assessment, intervention, and short-term outcomes of an inpatient with quadriparesis following ischemic stroke.
Methods: A 79-year-old woman with quadriparesis following ischemic stroke received two inpatient physiotherapy sessions on 13 and 15 April 2026. Interventions included therapeutic communication, deep breathing exercise, Manual Muscle Belly Tonus Stimulation, shoulder approximation, passive range of motion, active assisted range of motion, quadriceps setting exercise, and infrared rays during the second session. Pain, muscle strength, muscle tone, and functional dependence were assessed using the Numeric Rating Scale, Manual Muscle Testing, Ashworth Scale, and Barthel Index.
Results: Pain remained 0 at rest, during movement, and on pressure. Left sided muscle strength changed from 0/5 to 1/5, while right sided strength was 1/5 initially, with no separate follow up value available. The Ashworth Scale changed from 0 to 1, indicating a slight increase in muscle tone. The Barthel Index remained 0, indicating persistent total dependence in activities of daily living.
Conclusion: Short term changes were observed in left sided muscle strength and muscle tone, whereas pain and functional dependence remained unchanged. The findings are descriptive and cannot establish treatment effectiveness or causal attribution.