Martin's Journey Through Stroke Rehabilitation

Martin was a very active man in his mid 40’s who loved any outdoor adventure sports including rock climbing, mountaineering and bouldering. He was highly successful in his career and owned a small advertising company, which he thoroughly enjoyed. Martin had a left middle cerebral artery stroke (MCA), which meant that the right side of his body was affected. Initially his main symptoms were:

• Complete paralysis of his right upper limb and lower limb
• Difficulty forming words and sentences (expressive dysphasia)
• Difficulty understanding other people (receptive dysphasia)
• Unable to swallow safely (dysphagia) so had to be fed through a tube in his stomach (PEG)
• Unable to sit up and maintain his own balance
• Unable to keep control of his head and neck
• A hoist had to be used to safely transfer Martin from the bed to a specialist chair
• Unaware of the right side of his body (neglect)
• No sensation in his right arm, very minimal sensation in his right leg

 
Early days
 
Martin spent a total of 10 months in hospital, which included time in an acute stroke unit and then in a neuro-rehabilitation unit. During this time, some progress was made and Martin started to use an electric standing hoist to be transferred from his bed to the chair. This meant that his right leg had sufficient power in it to be able to take weight through it when using the hoist with the carers. His right arm had started to be able to joint in with daily tasks such as eating and washing but needed assistance.
 
Unfortunately, as Martin’s progress was relatively slow, he was discharged to a nursing home after 10 months of rehabilitation and looked after by carers 24 hours a day. Martin had been severely affected by fatigue but after 6 months in the nursing home, decided to start physiotherapy again to see if any further progress could be made.
 
Our specialist neurological physiotherapist, Katie, started seeing Martin twice a week at the nursing home. A thorough assessment was carried out and a treatment plan and individualised goals were set between them. Treatment varied and included:

• Work on alignment and awareness of Martin’s right side of his body
• Weight- bearing exercises for the upper and lower limb
• Supported standing practise
• Sitting balance exercises
• Stretching and positioning

 
After another 6 months, Martin was able to stand independently and step around to a chair using a specialist quad stick for support. He had also started taking a few steps.
 
1 year on
 
Martin’s mobility and balance progressed to such an extent that he was able to return home after a year of being discharged to the nursing home. He initially needed carers 3 times a day to support with showering, meals and shopping and was independent with all of his transfers and mobility including his stairs.
 
He is now independent with all of his activities of daily living and just has a cleaner to help with his housework once a week (which he is very pleased about!). Martin can drive an adapted car and go out independently to meet friends and socialise. He is still continuing with physiotherapy, which now even include sessions in the local climbing centre!
 
It is often reported that recovery gains start to significantly slow down after 6 months following a stroke and no further changes can be made after 2 years. Martin’s story is an important example that everyone should be treated as an individual rather than a statistic. In the right environment and with specialist rehabilitation, improvements can continue to be made for many years. 

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Bath Physio 01225 683007