title: Novel use of optokinetic chart stimulation to restore muscle strength and mobility in patients with subdural haemorrhage: two case studies.
abstract: OBJECTIVE
  The aim of these case studies is to report on the novel use of optokinetic chart stimulation to restore muscle strength and functional independence in severely disabled patients with subdural haemorrhage.
  
  
  METHODS
  An optokinetic chart was moved in front of the patient: from side to side, up and down and finally forwards and backwards. Once the patient could stand optokinetic chart stimulation was supplemented by sensory interaction for balance.
  
  
  RESULTS
  In first case study contractures in the knees improved from 90° short of full passive knee extension bilaterally to full active extension of the right knee joint and 25° short of full active extension of the left knee joint. The Barthel index improved from 0/20 to 18/20. In the second case study the Barthel Index improved from 0/20 to 18/20. From being bed bound the patients were independently mobile with a walking aid, on discharge.
  
  
  CONCLUSIONS
  With optokinetic chart stimulation leading to reversal of knee flexor contractures in one case and restoration of independent mobility in both cases, more research is needed to investigate use of optokinetic chart stimulation in patients with severe subdural haemorrhages and other traumatic brain injuries.
authors.affiliation: Department of Physiotherapy, Richard Stevens Stroke Unit, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford, Kent, UK. bchitambira@nhs.net
authors.forename: Benjamin
authors.initials: B
authors.lastname: Chitambira
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D003286:Contracture / Q000503:physiopathology; D005260:Female; D006408:Hematoma, Subdural / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D053580:Muscle Strength; D010775:Photic Stimulation / Q000379:methods*; D020127:Recovery of Function; D016896:Treatment Outcome