2025 Volume 16 Issue 2 Pages 84-91
【Introduction】 In this report, we describe the services of uninsured rehabilitation based on the course of the cases. 【Case presentation】 Case 1 was a 60‐year‐old woman with right hemiplegia due to left cerebral infarction; Case 2 was a 70‐year‐old woman with left hemiplegia due to right cerebral infarction; and Case 3 was a 50‐year‐old woman with left hemiplegia due to subarachnoid hemorrhage. For the cases in order, the SIAS lower limb motor items (Hip/Knee/Ankle) were (4/4/3), (3/3/0) and (2/1/0), respectively, while gait speeds were (0.74m/s), (0.37m/s) and (0.24m/s), respectively. 【Intervention and progress】 Eachofthethreecasesenrolledinaneight‐session plan (90 min per session; total cost ¥158,400) and received rehabilitation once weekly for two months. In all cases, a medical interview was conducted with the rehabilitation physician in addition to the functional training by the therapist. In the medical interviews, along with goals, prognosis and rehabilitation strategy, Case 1 discussed spasticity symptoms appearing during long‐distance walking, Case 2 examined exercise routines and medication management, and Case 3 considered orthosis. Among the three cases, the rehabilitation physician recommended botulinum‐toxin injections to treat spasticity in Case 1; the injections were subsequently administered at a nearby hospital, after which the patient showed improved gait performance and, ultimately, an increased frequency of community outings. 【Conclusion】 Integrating functional training with medical coordination was considered important not only for functional recovery but also for enhancing participants’ activity levels and social participation.
