The Benefits of Integrative Manual Therapy on Speech Impairment and Balance Secondary to Stroke

Author: Donna A. Dillon, LMT

Abstract: This case report illustrates the benefits of Integrative Manual Therapy on a status post stroke patient with a focus on Cranial Therapy. Prior to therapy, the patient presented with slurred speech, decreased comprehension, and loss of balance in walking. The patient's main goal was to be discharged from the hospital. The man was treated with several Cranial Therapy techniques. After the treatment was completed, the patient presented with significant improvements in speech and comprehension and an improvement in balance during gait. The patient was discharged from the hospital the very next morning.

Key Words: Stroke, Cerebral Vascular Accident (CVA), Speech, Cranial Therapy

History

The patient was a 78-year-old male. He recently had problems with high blood pressure. He suffered a sudden stroke one afternoon while watching television with his son. His vision and comprehension were suddenly reduced. He was in the hospital at the time of treatment. The patient complained of occasional headaches. In addition, He reported that he has steadily increased his sodium intake in the last few years.

The patient reported the following goals for treatment: He wants to be released from the hospital as soon as possible. To be released from the hospital, he has to be able to answer questions clearly without slurring his speech as well as be able to show he is no longer confused in his thinking, and be able to walk without balance problems.

Evaluation

The evaluation and treatment took place in the hospital. At the time of the evaluation, the patient was confused with slurred speech and he had difficulty walking without losing his balance. The patient presented with a mild Kyphosis of the thoracic spine and a mild to moderate forward head posture.

Treatment

The patient was treated with Integrative Manual Therapy techniques focusing on the cranium. The following techniques from The Cranial Therapy Series Level III were performed at around 7:30pm the day following his stroke (within 24 hours of his stroke). The techniques were performed in this order and held until the release occurred. These techniques were performed to open and release pressure at the cranio-cervical junction:

1. The Foramen Magnum Pressure Release

2. Jugular Foramen Pressure Release

3. Mastoid Foramen Pressure Release

The next morning, the patient answered questions with no slurring in his speech. He was able to answer questions about himself and current events showing he was no longer confused. His walking improved and he could ambulate without assistance or losing his balance. He was released from the hospital at 11:00am.