Physiotherapy for a patient with right hemiplegia after cerebral hemorrhage, who had difficulty with right leg swing during walking due to flexion of the right hip joint

Abstract

In this report, we describe the physical therapy prescribed for a patient with right hemiplegia following cerebral hemorrhage. The patient had difficulty in swinging off the toes because of right hip flexion during walking. This posture did not allow sufficient right hip joint extension from the right loading response to mid stance. In the left swing phase, right hip joint medial rotation from the flexion position caused her trunk to lean forward. She recovered to the right rear direction by right lateral bending and extension of the thoracic and lumbar spine, and right shoulder extension. Even in the terminal stance, right hip joint flexion persisted. The patient increased her right hip joint flexion in the right swing phase. Her walk weight movement was insufficient because right hip joint flexure was increased in the right terminal stance. As a result, the right foot caught on the floor during the right swing. We regarded gluteus maximus weakness to be the chief issue causing right hip joint flexion in the stance phase and conducted physiotherapy accordingly. We report the progress in gait improvement as a result of the prescribed physiotherapy.