Variability in lower limb spatiotemporal parameters after proprioceptive impairment in a case of pure sensory stroke associated with a pontine lesion: a case report

Abstract Background Patients with lacunar infarctions may develop pure sensory stroke (PSS), which is often accompanied by hemisensory impairment and gait ataxia. PSS due to pontine tegmental lacunar infarction is rare, and the characteristics of selective proprioceptive impairments associated with PSS remain unclear. This case report aims to describe a physiotherapy management program for a patient with variability in the spatiotemporal parameters of the lower limbs associated with proprioceptive impairment after PSS. Case presentation A 74-year-old female patient was admitted to our hospital with acute pontine tegmental lacunar infarction. Her muscle strength and trunk activity remained intact. However, the Lower Extremity Motor Coordination Test (LEMOCOT) and Gait Assessment and Intervention Tool (GAIT) scores were 16 times and 40 points, respectively. A buckling-knee pattern and variations in the spatiotemporal parameters were observed. Proprioception tests were performed. Proprioceptive impairments in knee and ankle joints were the primary functional impairments related to spatiotemporal parameters in gait. A 15-day treatment protocol incorporating transcutaneous electrical nerve stimulation (TENS) targeting the quadriceps femoris and gastrocnemius was implemented to address these proprioceptive impairments. The LEMOCOT (24 times) and GAIT (7 points) scores improved, and the proprioceptive impairment was alleviated. The patient was transferred to a rehabilitation hospital. Conclusions The findings of this report indicate that proprioceptive impairments have a direct negative effect on motor function, and manipulated proprioceptive stimulation has an immediate positive effect on discrete movement performance. The use of TENS for the evaluation and treatment of these phenomena were effective.