The Rehabilitation Nurse's Intervention in People with Spasticity: Case Report
DOI:
https://doi.org/10.56294/shp2025243Keywords:
Stroke, Rehabilitation, Nursing, SpasticityAbstract
Introduction: Stroke is one of the main causes of disability and mortality in Portugal. Early rehabilitation is essential to reduce complications such as spasticity, improve functionality and acilitate home reintegration.
Case report: Case report based on rehabilitation nursing interventions, following the CAse REport guidelines. A home rehabilitation program was implemented for a 50-year-old client with spastic left hemiparesis. Muscle strength, spasticity and pain were assessed using validated scales such as the Modified MRC Scale and the Ashworth Scale.
The intervention plan included passive and active-assisted mobilizations, transfer exercises and teaching the caregiver. There was a slight improvement in muscle strength and spasticity, but no impact on functional independence, according to the Barthel Index.
Conclusions: Early intervention and continuous monitoring by a Rehabilitation Nurse Specialist were fundamental to improving muscle strength and reducing spasticity. Caregiver training played a crucial role in implementing the care plan.
References
Instituto Nacional de Estatística (PT). Economic indicators: March 2025 [Internet]. Lisbon: INE; 2025 [cited 2025 May 6]. Available from: https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_destaques&DESTAQUESdest_boui=646027025&DESTAQUESmodo=2&xlang=pt
Ribeiro RM. Best practices in the care of people with post-stroke spasticity – Contributions from Rehabilitation Nursing [dissertation]. Bragança: Polytechnic Institute of Bragança; 2020 [cited 2025 May 6]. Available from: https://bibliotecadigital.ipb.pt/bitstream/10198/29430/1/Rui%20Miguel%20Morais%20Ribeiro.pdf
Figueiredo AR, Pereira A, Mateus S. Ischemic vs hemorrhagic stroke: survival rate. HIGEIA. 2020;3(1):35–45. Available from: https://revistahigeia.ipcb.pt/artigos_n3/03_Acidente_vascular_cerebral_isquemico_vs_hemorragico_taxa_de_sobrevivencia.pdf
Menoita E, Sousa L, Alvo I, Vieira C. Rehabilitating the elderly after stroke: contributions for resilient aging. Loures: Lusociência; 2012.
Doussoulin A, Rivas C, Bacco J, Sepúlveda P, Carvallo G, Gajardo C, et al. Prevalence of spasticity and postural patterns in the upper extremity post stroke. J Stroke Cerebrovasc Dis. 2020;29(11):105253. doi:10.1016/j.jstrokecerebrovasdis.2020.105253
Kuo CL, Hu GC. Post-stroke spasticity: a review of epidemiology, pathophysiology, and treatments. Int J Gerontol. 2018;12(4):280–4. doi:10.1016/j.ijge.2018.05.005Ipsen. The unexpected consequence [Internet]. [cited 2025 May 6]. Available from: https://asequelanaoesperada.com
Ordem dos Enfermeiros. Rehabilitation Nursing: Data collection tools for the documentation of Specialized Rehabilitation Nursing Care [Internet]. 2016 [cited 2025 May 6]. Available from: https://www.ordemenfermeiros.pt/arquivo/colegios/Documents/2017/InstRecolhaDadosDocumentacaoCuidEnfReabilitacao_Final_2017.pdf
Abreu J. Minimizing spasticity in the person affected by stroke [Internet]. 2015 [cited 2025 May 6]. Available from: https://www.ordemenfermeiros.pt/arquivo/projectos/Documents/Projetos_Melhoria_Qualidade_Cuidados_Enfermagem/HospitalMarmeleiros_MinimizarEpasticidadePessoaAcometidaAVC_Madeira.pdf
Matos MDF, Gonçalves Simões JA. Rehabilitation Nursing in the transition of people with motor impairment due to stroke: Systematic Literature Review. Rev Port Enferm Reabil. 2020;3(2):11–9. https://doi.org/10.33194/rper.2020.v3.n2.2.5770
Rocha IJ, Bravo MFM, Sousa LMM, Mesquita ACN, Pestana HCFC. Role of the rehabilitation nurse in postural balance recovery after stroke: case study. Rev Port Enferm Reabil. 2020 Oct 27;3(S1):5–17. https://doi.org/10.33194/rper.2020.v3.s1.1.5755
Gracies JM, Brashear A, Kocer S, Jech R, Roche N, Slawek J, et al. Early identification, intervention and management of post-stroke spasticity: expert consensus recommendations. J Exp Pharmacol. 2021;13:383–92. https://journals.sagepub.com/doi/epub/10.1177/11795735211036576
Santos DFF. Early rehabilitation of people with stroke. Évora: University of Évora; 2021 [cited 2025 May 6]. Available from: https://dspace.uevora.pt/rdpc/bitstream/10174/32168/1/Mestrado-Enfermagem_de_Reabilitacao-David_Filipe_Franco_dos_Santos.pdf
Zuchetto M, Engel F, Medeiros L, Hammerschmidt K, Schoeller S. Empathy in nursing care from the perspective of recognition theory: a reflective synthesis. Rev Cuid. 2019;10(3):e624. http://dx.doi.org/10.15649/cuidarte.v10i3.624
Faria A. The person after stroke: Transition from autonomy to dependence. Lisbon: University of Madeira; 2020 [cited 2025 May 6]. Available from: https://comum.rcaap.pt/bitstream/10400.26/9514/1/tese%20Ana%20Faria.pdf
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Copyright (c) 2025 Catarina Mateus, Helena Pestana, Luís Sousa, Sandy Severino (Author)
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