Saklecha Akshaya, Quershi Moh'd Irshad, Raghuveer Raghumahanti, Harjpal Pallavi
Department of Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, Maharashtra, 442001, India.
J Med Case Rep. 2024 Dec 7;18(1):598. doi: 10.1186/s13256-024-04929-x.
Gangliocapsular stroke is a specific type of hemorrhagic stroke that primarily affects the basal ganglia and internal capsule due to rupture of the lenticulostriate perforating arteries. Patients afflicted with this condition often present with contralateral motor deficits, particularly affecting the upper extremity. Additionally, these individuals may experience challenges in coordination and stability, largely due to the involvement of the shoulder and scapular girdle. The stability of proximal joint is essential to increase the limited functions and distal movement of the upper extremities. Malalignment of scapula further complicates the execution of daily activities, profoundly affecting patients' overall well-being and reducing engagement in society. Therefore, restoring upper limb function is imperative for a successful return to daily routines, with a focus on improving arm function being a crucial aspect of stroke therapy. Many methods have been explored for enhancing the function of upper limb in stroke, but the emphasis is more toward developing independence in grasp and improving scapular stability is often neglected. This case reports aim to examine the effect of targeted scapular proprioceptive neuromuscular facilitation on upper limb function in a patient who suffered a gangliocapsular stroke.
A 54-year-old South Asian man was presented with left-sided hemiplegia following a right gangliocapsular stroke. He reported challenges in using his left upper limb and weakness of the left side of the body, which severely impaired his ability to perform activities of daily living. Radiological findings indicated a right gangliocapsular hemorrhage. The patient underwent a 4-week physiotherapy rehabilitation program, with outcome measures including the palpation meter, Fugl-Meyer assessment of upper extremity, and functional independence measure. Following the treatment period, significant improvements were observed in scapular alignment and upper limb functions, underscoring the effectiveness of rehabilitation strategies for optimal outcomes and recovery.
The study underscores the beneficial outcomes of targeted scapular muscles through facilitatory movement patterns to improve upper extremity function in gangliocapsular stroke. Implementing scapular proprioceptive neuromuscular facilitation techniques led to a beneficial change in scapular positioning, consequently improving upper limb function, and quality of life significantly.
豆状核囊卒中是一种特殊类型的出血性卒中，主要由于豆纹状穿支动脉破裂，影响基底节和内囊。患有这种疾病的患者通常会出现对侧运动功能障碍，尤其是上肢。此外，这些个体可能在协调和稳定性方面存在困难，这主要是由于肩部和肩胛带受累。近端关节的稳定性对于增加上肢有限的功能和远端运动至关重要。肩胛骨排列不齐会使日常活动的执行更加复杂，严重影响患者的整体幸福感并减少社会参与度。因此，恢复上肢功能对于成功回归日常生活至关重要，改善手臂功能是卒中治疗的关键方面。已经探索了许多方法来增强卒中患者的上肢功能，但重点更多地放在发展抓握独立性上，而改善肩胛骨稳定性常常被忽视。本病例报告旨在研究针对性肩胛骨本体感觉神经肌肉促进法对一名患有豆状核囊卒中患者上肢功能的影响。
一名54岁的南亚男性在右侧豆状核囊卒中后出现左侧偏瘫。他报告说使用左上肢有困难，身体左侧无力，这严重损害了他进行日常生活活动的能力。影像学检查结果显示右侧豆状核囊出血。患者接受了为期4周的物理治疗康复计划，结果测量包括触诊仪、上肢Fugl-Meyer评估和功能独立性测量。治疗期结束后，观察到肩胛骨排列和上肢功能有显著改善，强调了康复策略对实现最佳结果和恢复的有效性。
该研究强调了通过促进性运动模式针对肩胛骨肌肉以改善豆状核囊卒中患者上肢功能的有益结果。实施肩胛骨本体感觉神经肌肉促进技术导致肩胛骨位置发生有益变化，从而显著改善了上肢功能和生活质量。
