Early Introduction Of Graded Unilateral Squats Training In Post Traumatic Brain Injury Hemiparetic Patient - A Case Report

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Dr. Neha Ingale Chaudhary (Pt), Dr. Sachin Chaudhary.(Pt), Muzahid K Sheikh, Gendalal Vaidya

Abstract

Gait training to facilitate the use of the paretic limb for persons with hemiparesis continues to be of interest to those in the clinical research domain. The purpose of this case report was to assess the outcomes of a repeated unilateral squats treatment, initiating with the paretic limb, on functional mobility, endurance and gait kinematic parameters in a person with hemiparesis. The participant was an40-year-old male 7 months status post right hemiparesis a K/C/O traumatic brain injury ( diffuse axonal injury), who reported overall good health. Patient’s main complaint was difficulty in moving right upper and lower limb since 7 months (LL>UL).


The participant was asked to perform unilateral squats with his paretic limb initially with maximal, moderate and minimal support and once he was confident enough, then without support. The training duration for each treatment session was 10-15 min/dayin outpatient rehabilitation. The participant completed ten sessions spanning over 3 weeks. The outcome measure used to identify motor recovery was with the help of Lower extremity functional scale (LEFS). In addition, timed up and go test, 6-min walk test (6 MWT) and gait kinematics were assessed to examine mobility and gait. The Lower extremity functional scale (LEFS) score, 6 MWT and Timed up and go test showed a meaningful change. With respect to gait kinematics, hip flexion on the paretic limb was improved. Unilateral squats training seemed to be an effective treatment to improve strength, co contraction, alteration of strength and range of contraction of the agonists and antagonists of lower extremity when it is appropriately targeted and started early in the intervention. The patient's level of assistance for mobility and activities of daily living improved from minimal assistance to modified independence without use of an assistive device.


 


 


 

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Dr. Neha Ingale Chaudhary (Pt), Dr. Sachin Chaudhary.(Pt), Muzahid K Sheikh, Gendalal Vaidya