BARRIERS TO POST-STROKE REHABILITATION IN RURAL AREAS: A CASE REPORT OF NEGLECTED RIGHT HEMIPARESIS AND DROP FOOT

Diniafelsa Wola; Annisa Ayu Nazalia; Andalassari Andalassari

doi:10.14710/dmj.v15i3.53734

DOI: https://doi.org/10.14710/dmj.v15i3.53734

BARRIERS TO POST-STROKE REHABILITATION IN RURAL AREAS: A CASE REPORT OF NEGLECTED RIGHT HEMIPARESIS AND DROP FOOT

*Diniafelsa Wola - Department of Physical Medicine and Rehabilitation, Tuanku Imam Bonjol Hospital, Pasaman, West Sumatra, Indonesia 31166, Indonesia

Annisa Ayu Nazalia - Department of Physical Medicine and Rehabilitation, Tuanku Imam Bonjol Hospital, Pasaman, West Sumatera, Indonesia, Indonesia

Andalassari Andalassari - Department of Neurology, Tuanku Imam Bonjol Hospital, Pasaman, West Sumatera, Indonesia, Indonesia

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

BibTex Citation Data :

@article{dmj53734,
    author = {Diniafelsa Wola and Annisa Nazalia and Andalassari Andalassari},
    title = {BARRIERS TO POST-STROKE REHABILITATION IN RURAL AREAS: A CASE REPORT OF NEGLECTED RIGHT HEMIPARESIS AND DROP FOOT},
    journal = {Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal)},
  volume = {15},
    number = {3},
    year = {2026},
    keywords = {delayed rehabilitation, drop foot, hemiparesis, post-stroke rehabilitation, rural health services.},
    abstract = {  Background:  Stroke is a leading cause of disability worldwide. Post-stroke rehabilitation plays a critical role in restoring motor function and improving patient’s quality of life. Early and continuous rehabilitation is especially crucial during the first two years. In rural areas, limited access to healthcare, low awareness, and socioeconomic barriers often delay rehabilitation, leading to long-term disability.  Case Presentation :  This is a case report of a 63-year-old male, three years post-stroke with untreated right hemiparesis and drop foot, was managed through a structured rehabilitation program involving physiotherapy, ankle foot orthosis (AFO), and a home-based, family-supported approach. After eight weeks of intervention, the patient showed modest improvements. Muscle strength in the affected upper limb increased (from 1/5 to 2/5 strength for wrist extensors and finger flexors) and not increased in the affected lower limb (1/5 strength for ankle dorsiflexors and ankle plantarflexors). Balance scores improved (Berg Balance Scale from 22 to 29), and the Timed Up and Go (TUG) test time decreased from 32 to 28 seconds. The patient also reported increased confidence and resumed limited social engagement.  Conclusion :  This case demonstrates that delayed rehabilitation in rural stroke patients can lead to persistent disability. Early, continuous rehabilitation, community-based support, and family education are essential for improving outcomes and preventing similar cases. },
   issn = {2540-8844},   pages = {294--298}  doi = {10.14710/dmj.v15i3.53734},
    url = {https://ejournal3.undip.ac.id/index.php/medico/article/view/53734}
}

Citation Format:

Abstract

Background: Stroke is a leading cause of disability worldwide. Post-stroke rehabilitation plays a critical role in restoring motor function and improving patient’s quality of life. Early and continuous rehabilitation is especially crucial during the first two years. In rural areas, limited access to healthcare, low awareness, and socioeconomic barriers often delay rehabilitation, leading to long-term disability. Case Presentation : This is a case report of a 63-year-old male, three years post-stroke with untreated right hemiparesis and drop foot, was managed through a structured rehabilitation program involving physiotherapy, ankle foot orthosis (AFO), and a home-based, family-supported approach. After eight weeks of intervention, the patient showed modest improvements. Muscle strength in the affected upper limb increased (from 1/5 to 2/5 strength for wrist extensors and finger flexors) and not increased in the affected lower limb (1/5 strength for ankle dorsiflexors and ankle plantarflexors). Balance scores improved (Berg Balance Scale from 22 to 29), and the Timed Up and Go (TUG) test time decreased from 32 to 28 seconds. The patient also reported increased confidence and resumed limited social engagement. Conclusion : This case demonstrates that delayed rehabilitation in rural stroke patients can lead to persistent disability. Early, continuous rehabilitation, community-based support, and family education are essential for improving outcomes and preventing similar cases.

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Keywords: delayed rehabilitation, drop foot, hemiparesis, post-stroke rehabilitation, rural health services.

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Section: Case Report

Language : EN

In Vol 15, No 3 (2026): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)

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