Cerebral Vascular Accident Confounded by Parkinson's Disease: A Case Report

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Moseman, Jacqueline
Parkinson's disease; physical therapy; acute care
project description
BACKGROUND AND PURPOSE: There is a plethora of research pertaining to thetreatment of cerebral vascular accidents or Parkinson’s disease, but there is limitedresearch about the treatment of these conditions in combination, especially during a short-term hospitalization. The purpose of this case report is to describe the physical therapy intervention and outcome for a patient post cerebral vascular accident with preexisting Parkinson’s disease during a short-term hospital stay.CASE DESCRIPTION: The patient was a 76-year-old Caucasian male hospitalizedafter a possible mild cerebral vascular accident. The patient also had Parkinson’s disease that limited his functional mobility and his ability to perform activities of daily living prior to his hospitalization. His Parkinson’s symptoms were exacerbated during his initial admission to the hospital.INTERVENTION: Gait training and lower extremity strengthening were the primaryinterventions utilized to address the functional mobility and activities of daily livingdeficits. As the patient improved interventions were progressed by increasing thedifficulty and decreasing assistance during his three physical therapy treatment sessions.OUTCOMES: During the patient’s three-day acute care stay he improved his Five Time-Sit-to-Stand score by 24 seconds and his ambulation distance from 10 feet to 300 feet. The patient was discharged to a skilled nursing facility for a short-term stay to continue work on gait and lower extremity strengthening prior to returning home.DISCUSSION: Parkinson’s disease in combination with a possible cerebral vascular accident led to the patient’s functional impairments and activity limitations. The outcomes of this case report support previous research that has demonstrated intensive gait training and lower extremity strengthening may contribute to return to functional mobility and activities of daily living during a short-term hospital stay, however further research is needed to establish intervention effects in the greater population. As demonstrated in previous studies, this case report also supports the use of external feedback in combination with lower extremity strengthening to improve sit to stand transfers and ambulation ability. Recommendations for further research include studying the carryover of short-term functional training for patients with Parkinson’s disease.