The Effect of Associated Parkinsonism on Rehabilitation in Stroke Patients: A Case Series

Stroke and Parkinson's disease are 2 major causes of movement impairment and a decreased ability to perform daily activities. The aim of this case series was to demonstrate the difficulty of rehabilitation in stroke patients with accompanying parkinsonism. Four stroke patients with parkinsonism who underwent rehabilitation at the Physical Medicine and Rehabilitation Clinic between March and May of 2016 were evaluated. The Standardized Mini-Mental State Examination (SMMSE), the Functional Independence Measure (FIM), the Barthel Index (BI), the Berg Balance Scale (BBS), and the Stroke Impact Scale version 3.0 (SIS) were used in the assessment. Of the 4 patients, 3 were female, and the mean age was 74.5±9.3 years. The mean hospital stay was 19±5.3 days. The initial test scores recorded were low, and they remained low at the time of discharge. After rehabilitation, the mean FIM score in the group was 42% of the maximum possible score, the mean SMMSE was 55%, the BI was 18%, the BBS was 0.08%, and the SIS was 25%. Three patients required a wheelchair, and 1 patient could ambulate with a walker at discharge. A stroke accompanied by parkinsonism negatively affects mobility and functional status, primarily through the deterioration of balance. In this study, cognitive function was reduced to half of the maximum, and the balance and function loss was more than 50%. Barthel index; berg balance scale; functional independence measure; mini-mental state examination; parkinsonism; stroke; stroke impact scale.