The Re-education of Trunk Stability and Functional Sit-to-Stand Movement Using Neuroplasticity Principles in a Patient with Intracerebral Hemorrhage: A Case Report

Purpose This case report aims to evaluate the efficacy of a neuroplasticitybased intervention, grounded in the Bobath concept, for improving trunk stability and functional sit tostand movement in a patient with hemiplegia following an intracerebral hemorrhage(ICH). Methods A 45yearold male with right hemiplegia and significant functional limitations underwent a foursession therapeutic intervention using Bobathbased manual facilitation(pelvic stability and intrinsic foot muscle activation). This study employed an AB singlecase experimental design focused on foundational structural alignment and dynamic functional control. Outcome measures included the Trunk Impairment Scale(TIS) for clinical trunk control, digital image analysis(ImageJ) for kinematic assessment of trunk lateral flexion and knee valgus angles, and highresolution pressure mapping(Zebris FDM) for kinetic evaluation of weight distribution. Results Following the intervention, the TIS score improved from 11 to 16 points. Kinematic analysis revealed a reduction in excessive trunk lateral flexion from 22.104° to 18.127° and a decrease in the knee valgus angle from 30.523° to 28.334°. Kinetic data demonstrated a significant 17% shift in average force toward the affected right side, increasing from 27% to 44%. Qualitatively, the patient reported enhanced proprioceptive awareness and required markedly less assistance for functional transfers. Conclusion This study suggests that even in chronic stroke recovery, neuroplasticitybased interventions focusing on distalproximal relationships can effectively inhibit compensatory patterns and restore functional movement. While promising, these results from a singlecase study require systematic validation through future research with larger, diverse clinical populations.