Patient Information

Patient is a 47-year-old male with a diagnosis of a severe right-side hemorrhagic stroke with right intraparenchymal hemorrhage resulting in L hemiparesis.

Neuroplasticity and Brain Mapping

These principles were used in this patient’s skilled intervention Neuro program.

  • The brain can change its own structure and function through thought and activity.
  • A damaged brain can often reorganize itself so that when one part fails another can substitute.
  • Learned non-use can arise from early failures in stroke patients.
  • Traditional rehabilitation usually ends when there is a plateau in performance. These learning plateaus are part of a plasticity-based learning cycle. Treatment needs to be extensive.
  • When it comes to allocating brain-processing power, brain maps are governed by competition for precious resources and the principle of “use it or lose it.”
  • If certain key pathways are blocked, then the brain uses older pathways to go around them. Secondary neuronal pathways are unmasked and with use, strengthened.
  • Brain scans show that in action and imagination, many of the same parts of the brain are activated. That is why visualizing can improve performance.

Functional Outcomes

  • Day 1: standing performing weight shifts in Body Weight Support System (BWSS) with 120 lbs offloading
  • Day 15: treadmill ambulation BWSS offloading 105 lbs x 260 ft
  • Day 36: walking in hallway BWSS offloading 100 lbs x 375 ft
  • Day 61: walking in hallway BWSS offloading 75 lbs x 300 ft
  • Day 82: walking in hallway BWSS offloading 40 lbs x 300 ft
  • Day 89: walking in hallway BWSS offloading 30 lbs x 300 ft
  • Day 97: walking in hallway BWSS with 0 lbs x 105 ft
  • Day 100: parallel bars 104 ft no BWSS used

View poster to see progression of the patient’s gait performance with weight offloading using the BWSS: Neuroplasticity and Rehab Outcomes (PDF format)

By Karen Swisher, PTA & Jeremy Osmond, DOR/DPT, Provo Rehab and Nursing, Provo, UT