Improved Mobility and Quality of Life Through Physical Activity Management in a Stroke Patient With Peripheral Arterial Disease: A Case Report

Stroke and peripheral arterial disease (PAD) are common causes of impaired walking and reduced physical activity levels, both of which contribute to a decline in quality of life (QOL). Effective rehabilitation strategies that integrate functional training and physical activity management are essential for improving walking ability and QOL in patients with such multimorbidity. This case report describes a 70-year-old woman with left hemiparesis due to branch atheromatous disease and PAD (Fontaine stage IIb). She participated in a comprehensive rehabilitation program that combined functional training and physical activity management using a triaxial accelerometer. The intervention included strength training, treadmill walking, and balance exercises conducted seven days per week for 60-120 minutes per day, targeting a Borg scale rating of 13-15 for lower limb fatigue. Physical activity management focused on reducing sedentary behavior (SB) and increasing light-intensity physical activity (LPA) and daily step counts through goal setting and real-time feedback from the accelerometer. After 39 days, her six-minute walk distance increased to 190 meters, walking speed improved to 1.11 m/s, and initial claudication distance extended to 150 meters. Her daily step count rose to 3,204, LPA increased to 381 minutes per day, and SB decreased to 479 minutes per day. Health-related QOL, assessed using the Walking Impairment Questionnaire (WIQ) and the Vascular Quality of Life Questionnaire (VascuQOL), also showed marked improvement. This case suggests that intensive functional training combined with high-frequency physical activity management may be effective for improving mobility and QOL in patients with multimorbidity in convalescent rehabilitation wards.