Novel use of optokinetic chart stimulation to restore muscle strength and mobility in patients with subdural haemorrhage: Two case studies

Abstract

Background and purpose: The aim of these case studies is to report on the novel use of optokinetic chart stimulation to restore muscle strength and functional independence in severely disabled patients with subdural haemorrhage.

Methodology: An optokinetic chart was moved in front of the patient: from side to side, up and down and finally forwards and backwards. Once the patient could stand optokinetic chart stimulation was supplemented by sensory interaction for balance.

Results: In first case study contractures in the knees improved from 90° short of full passive knee extension bilaterally to full active extension of the right knee joint and 25° short of full active extension of the left knee joint. The Barthel index improved from 0/20 to 18/20. In the second case study the Barthel Index improved from 0/20 to 18/20. From being bed bound the patients were independently mobile with a walking aid, on discharge.

Discussion: With optokinetic chart stimulation leading to reversal of knee flexor contractures in one case and restoration of independent mobility in both cases, more research is needed to investigate use of optokinetic chart stimulation in patients with severe subdural haemorrhages and other traumatic brain injuries.

• Neurorehabilitation
• optokinetic chart stimulation
• subdural haemorrhage

Acknowledgements

My first acknowledgement is to the patients who gave written informed consent for their data to be used in this report. I would also like to acknowledge Ann McGovern, Michelle Warren and Emma Loader who alternated in carrying out the OKCSIB protocol under the author’s supervision.