Document Type

Case Report


Physical Therapy & Rehabilitation Science

Degree Name

DPT (Doctor of Physical Therapy)

Session and Year of Graduation

Fall 2017


Laura Frey Law


Background: Hemorrhagic strokes affect 16-33 per 100,000 individuals per year, with 25% of individuals with right-sided strokes developing symptoms of left neglect. Despite the high prevalence and potential for low functional outcomes in these populations, research to figure out the most effective physical therapy interventions for this group is severely lacking. The purpose of this case report is to demonstrate the potential for use of the neurodevelopmental treatment (NDT) in individuals with stroke and hemispatial neglect, and to encourage further research on the topic. Case Description: The patient was a 49-year old female who suffered from an acute right temporal and basal ganglia parenchymal hemorrhage that caused left-sided hemiplegia, left hemispatial neglect, and cognitive deficits. She presented with gait abnormalities, inattentiveness to left-sided movements, and difficulty with functional movements. Interventions: The primary intervention was the use of NDT techniques, progressing through movements that follow the neurodevelopmental sequence and use somatosensation and proprioception to improve functional movement. In this case, the patient performed exercises in sitting, quadruped, half-kneeling, and tall-kneeling while progressing difficulty to challenge balance and increase activation of left-sided muscles. Outcome Measures: The primary outcome measures used in this case were the Berg Balance Scale and the Functional Independence Measure. Through evaluation with these measures, the patient demonstrated minimal clinically important differences in both outcomes. Discussion: The patient’s dramatic improvements in all functional movements suggests that use of NDT techniques may be beneficial in treatment of individuals post-stroke who demonstrate symptoms of hemispatial neglect. However, additional research is needed to evaluate how effective these methods are in comparison to conventional treatment in a larger population.


Neurologic - Stroke & SCI


9 pages


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