hi all! my shifty issue that id love some advice on is good old weight shift - something that almost every student will come across at some time on neuro prac! Im currently treating a pt who suffered a R thalamic stroke about 2 years ago who is currently recieving outpt rehab to improve his mobility.
At the time of his stroke he was visiting family in a 3rd world country, thus the first 4 months of acute medical treatment involved little (if any) physio. He currently ambulates with the assistance of a walking stick and whilst his gait is functional he displays many compensations.
One of his biggest issues is a reluctance to weight shift to the left, and he actively resists any kind of hands-on facilitation with any task(resisting and fixing to such a degree that even the supervisor was suprised!). I believe some cultural issues are also affecting our ability to have close contact with him. So far ive tried to limit hands-on contact as he dislikes this so much, and opted for verbal cues which sometimes work (he also has limited english).
To assist with weight shifting activities ive tried giving him a target to reach for so he uses internal displacement over my external facilitation, and also prone standing over a plinth to allow him to get some selective control of the L leg and also get him used to some weightbearing on the L whilst feeling safe and supported.
I'd love to hear if anyone else has had pts who really dislike you coming into their personal space and who activily fix throughout the trunk and upper limb when you try to displace them, and any suggestions as to how i might get my much-desired weight shift to the left side!! thanks
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