Case Study of a Chronic Stroke Patient with Lower Limb Spasticity Who Showed Improvement in Walking Endurance after a Physical Therapy Intervention with Botulinum Therapy and Functional Electrical Stimulation

Abstract

[Purpose] Although spasticity of the lower limbs in chronic stroke patients causes gait disturbance, there are few reports of useful interventions to improve their walking ability. The purpose of this paper is to report the course of an intervention for a chronic stroke patient who showed improvement in walking endurance after a physical therapy intervention with botulinum therapy and functional electrical stimulation (FES). [Participant and Methods] The case was a 39-year-old female who had right paraplegia and spasticity of the lower limbs due to left parietal lobe subcortical hemorrhage 9 years earlier. During the course of 24 months, botulinum therapy was administered 4 times for lower limb spasticity, and in addition to the usual interventions, gait practice with FES was performed in outpatient physical therapy. The 6-minute walk test (6MWT) was evaluated as an index of walking endurance. [Results] The mean intervention time was 10.3 hours/month. The 6MWT distances before and after the intervention were 162 m and 275 m, respectively. [Conclusion] The results suggest that physical therapy combined with botulinum therapy and FES may contribute to the improvement of walking ability of chronic stroke patients with lower limb spasticity.