title: Ballism after stroke responds to standard physical therapeutic interventions.
abstract: OBJECTIVE
  To report the effects of noninvasive standard physical therapy (PT) interventions on an involuntary movement disorder after stroke.
  
  
  METHODS
  Single case with clinical follow-up over 2 years.
  
  
  METHODS
  Inpatient stroke and rehabilitation services and outpatient clinic.
  
  
  METHODS
  A man with acute bilateral ballism after unilateral subthalamic infarction.
  
  
  METHODS
  Rhythmic coordinated bilateral limb movements and firm tactile stimulation to the hand.
  
  
  METHODS
  We had not anticipated that dyskinesia itself would specifically improve during treatment. Consequently, we used qualitative clinical observations, including review of videotaped performance, and self-reported limb control. Hypotheses concerning treatment effects were developed after data collection.
  
  
  RESULTS
  Involuntary movements recurrently improved within treatment sessions.
  
  
  CONCLUSIONS
  PT may improve dyskinesia after stroke. The benefit may be adjunctive or alternative to current invasive treatments of movement disorders after brain injury and merits confirmation. The improvements are consistent with current research indicating that (1) intact cortical, subcortical, cerebellar, and spinal areas interact to generate bilateral rhythmic limb movements that can overcome dyskinesia and (2) tactile stimulation can improve motor deficits associated with basal ganglia disorders. Finally, because functional activities assessments improved our evaluation of ballism, these should be routinely used along with conventional neurologic examination to assess involuntary movement disorders.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Alabama, 619 19th Street, Birmingham, AL 25249, USA. vwmark@uab.edu
authors.forename: Victor W
authors.initials: VW
authors.lastname: Mark
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Oberheu
authors.forename: Cathy
authors.initials: C
authors.lastname: Henderson
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Woods
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D002998:Clonazepam / Q000627:therapeutic use; D004185:Disability Evaluation; D020820:Dyskinesias / Q000209:etiology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D020521:Stroke / Q000150:complications*
chemical_list: D000927:Anticonvulsants; D002998:Clonazepam