Following a brain haemorrhage from an undetected aneurysm this young man presented with severe proximal weakness in his trunk and pelvis, both on his hemiplegic side, but more significantly on his ipsilesional side (or non-hemiplegic side).
The reticulospinal descending system has influence over muscles of the neck, trunk and proximal limbs bilaterally. Major functions of the reticulospinal system include postural control, initiation and regulation of locomotion, and proximal control of limb movements. Therefore weakness in this system means it cannot create stability in the trunk and proximal girdles (shoulder and pelvis) for actions up against gravity, such as standing, balancing, reaching, walking, which all became very difficult in function.
Targeting and treating this young mans trunk activity and strength, on both sides, and developing his kinetic chain bilaterally, to hold himself up against gravity effectively, has improved his function and balance so much! From not being able to balance when he was first discharged from hospital (first photo), to carrying his own 6ft. Christmas tree on his shoulder 2yrs later.
Well done to him!
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