Observation of meaningful activities: a case study of a personalized intervention on poststroke functional state

Stroke rehabilitation coordinated by specialist teams and oriented toward functional activities is now common. However, the potential remains for improved outcome, and new methods for improving rehabilitation are being developed. Observation of functional, meaningful activities, via DVD, has been suggested as a technique that may be effective. This case study aimed to investigate the effect of an individualized program of observation for functional status after stroke.

The case study participant was a 44-year-old man, 12 months after a right intracerebral hemorrhage, with a Scandinavian Stroke Scale (SSS) score of 42. He was independently mobile using a cane. He viewed, with the instructions to understand and imitate, four DVDs of meaningful daily activities filmed from first- and third-person visual perspectives. Pre- and postintervention measures administered in the participant's home were the SSS, Postural Assessment Scale (PASS), Timed Up and Go test (TUG) with manual and cognitive components, a fluidity scale, and the Stroke-Specific Quality of Life Scale.

Improvements were observed in the TUG and the fluidity scale. Small but clinically insignificant changes were observed in the PASS. The patient also felt confident to progress to walking without his cane.

The findings suggest that, for this relatively young and motivated individual, observation of meaningful activities was an important part of his stroke rehabilitation.