# Modified Constraint-Induced Movement Therapy for Improving Balance and Gait in a Case of Ganglio-Capsular Infarct: A Single-Case Study

## TL;DR

A 52-year-old man with a brain infarct improved balance and gait through modified constraint-induced movement therapy and physiotherapy.

## Contribution

This case study introduces modified constraint-induced movement therapy as an effective rehabilitation approach for ganglio-capsular infarct.

## Key findings

- Modified constraint-induced movement therapy improved balance and gait in a patient with ganglio-capsular infarct.
- Clinical outcomes showed significant improvements in balance, strength, coordination, and tone over six weeks of therapy.

## Abstract

The ganglio-capsular region consists of the basal ganglia nuclei (caudate nucleus and lentiform nucleus), thalamus, and internal capsule. A disorder of the ganglio-capsular region typically presents with movement disturbance and cognitive impairment. This report presents the case of a 52-year-old male who was diagnosed with acute non-hemorrhagic infarct in the right parietal-occipital-temporal region predominantly involving the cortex and in the right ganglio-capsular region. The patient exhibited typical symptoms, which include impaired reflexes, decreased strength, reduced range of motion, and tone abnormalities. Targeted early physiotherapy intervention (TERI) was initiated from the bedside in the intensive care unit (ICU). Modified constraint-induced movement therapy (mCIMT) along with conventional therapy was selected as the rehabilitation approach for the case as it deals with "forced use" of the affected extremities, which addresses "learned non-use." The case was managed for a duration of six weeks, in which clinical outcomes, including the Berg Balance Scale (BBS), 10-meter walk test (10MWT), functional reach test (FRT), dynamic gait index (DGI), trunk impairment scale (TIS), and fall efficacy test (FET), reported crucial changes in balance, strength, coordination, and tone, which improved the quality of life of the patient.