Case 14: Functional Change in a Client With Recurrent Stroke History

A client presented with a complex neurological history, having experienced multiple strokes over the past eight years. Earlier medical history included intracranial surgery several decades ago, during a period when surgical techniques and materials were limited. Subsequent neurological events resulted in cumulative impairments affecting vision, hearing, speech processing, and right-sided motor control.

Balance and weight-distribution assessment as part of task-specific neuromuscular training in a complex neurological presentation.

At presentation, functional limitations were significant. The right upper limb showed minimal voluntary control across the shoulder, elbow, wrist, and fingers, with markedly reduced sensation below the elbow. The right lower limb had limited weight-bearing capacity, requiring a wheelchair and assistive devices for mobility. Standing was painful, and walking relied heavily on compensatory use of the left leg.

Force plate assessment demonstrated a pronounced asymmetry in load distribution, with the majority of body weight borne through the left leg and minimal contribution from the right. Lateral and medial control of the right leg was nearly absent, and active movement range was severely restricted.

Neurofunctional assessment identified altered breathing mechanics, limited movement responses, and widespread fascial restriction. Intervention focused on neuromuscular feedback, task-specific movement training, breathing mechanics, and progressive load tolerance rather than passive treatment.

Over successive sessions, the client demonstrated measurable functional change. The right leg gradually regained the ability to lift, move laterally, and participate in controlled flexion and extension tasks, with active control improving to approximately 60–70% of available range. Weight-bearing capacity became more balanced, allowing near-equal load distribution through both legs during standing without significant pain.

Encouragingly, the right hand began to show early voluntary finger responses, and the shoulder demonstrated improved elevation and protraction control. Seated hip flexion range improved substantially without reliance on compensatory support, and deeper squat patterns became achievable with improved hip and knee movement.

The client reported that despite years of ongoing care, he had previously been advised that active movement training was unnecessary due to perceived inability to move. This case illustrates how carefully graded, task-specific training and neuromuscular feedback may support functional change even in long-standing neurological presentations. All observations are reported as functional responses rather than prognostic outcomes.

Clinical Practice: Heal Young Massage

Evidence-based remedial massage and movement rehabilitation services.