Experience of orthotic therapy for hemiplegic stroke patient with congenital bilateral foot deformities

Abstract

We report a case of severe right hemiplegia with congenital bilateral foot deformities and severe obesity. On day 19 of onset, a 38-year-old man was admitted to our hospital after left putaminal hemorrhage. We prescribed right knee-ankle-foot orthosis and left foot orthosis each with high quarter shoes, which had modification for pes equinocavovarus deformity. The use of an orthosis contributed to standing stability, foot pain reduction and reduction in the amount of assistance. As a result, the patient was able to repeat task-oriented training in anti-gravity position such as standing, stepping, and walking, which were difficult to perform without orthosis. On day 154, the patient was able to independently walk indoors with a bilateral lower limb orthosis and one side crutch, and became independent in basic activities of daily living except for bathing and stairs. On day 198, the patient was admitted to a support facility for persons with disabilities to train him to live alone. In recent years, there has been increasing demand for rehabilitation of patients with multiple disabilities. We need to provide the best orthotic therapy for each individual case to improve their prognosis.