Functional Recovery in a Geriatric Woman with Late-Subacute Stroke and Vascular Dementia: A Case Report

Authors

  • Ferdinand D Kurniawan Physical Medicine & Rehabilitation, Padjadjaran University
  • Novitri Sumardi Physical Medicine & Rehabilitation Department, Medical Faculty, Padjadjaran University, Bandung, Indonesia
  • Deta Tanuwidjaja Physical Medicine & Rehabilitation Department, Medical Faculty, Padjadjaran University, Bandung, Indonesia
  • Vitriana Biben Physical Medicine & Rehabilitation Department, Medical Faculty, Padjadjaran University, Bandung, Indonesia

DOI:

https://doi.org/10.28932/jmh.v8i2.11889

Keywords:

task-oriented-rehabilitation, neurorehabilitation, late-subacute stroke, vascular dementia

Abstract

This case report presented task-oriented rehabilitation of a 66-year-old woman with vascular dementia due to late-subacute stroke. The patient exhibited cognitive and mobilization decline that led to significant functional impairments in her daily activities, including her hobby of gardening, looking after her grandchildren, and partial dependence on self-care. This report highlighted the effectiveness of task-oriented rehabilitation for a geriatric patient with late-subacute stroke, in which isolated rehabilitation was thought to be less effective. A multidisciplinary approach combining executive-function and divided-attention training, tailored to the patient's individual needs and goals for resuming avocational activities (gardening and caring for her grandchildren, including playing catch and having them sit on her lap), was implemented. The intervention comprised task-oriented occupational therapy and cognitive rehabilitation targeting executive function and divided attention. The patient showed notable improvements, with avocational activities performed daily and independently within 3 months of task-oriented rehabilitation. The MOCA-Blind score improved from 12 to 15 out of 22, BMI increased from 12 to 15.22 kg/m², and the Zarit Burden Interview score decreased from 22 to 11. Combined-personalized, task-oriented rehabilitation was effective in late-subacute stroke rehabilitation, especially in the geriatric population in which the consequences of aging limit functional recovery.

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References

Khader Basha AS. Effect of structured home exercises on functional independence in stroke survivors. Physiotherapy - The Journal of Indian Association of Physiotherapists. 2021;15(1):43–9.

Oppici L, Hestetun-Mandrup AM, Pacheco MM, Simonsen EH, Opheim A, Rafsten L, et al. Strengths, limitations, and way forward of home-based rehabilitation practices after stroke: a scoping review. BMC Health Serv Res. 2026;26(1):447.

Kumral E, Bayam FE, Arslan H, Orman M. Associations Between Neuroanatomic Patterns of Cerebral Infarctions and Vascular Dementia. J Neuropsychiatry Clin Neurosci. 2021;33(1):49–56.

Ikeji R, Nozoe M, Yamamoto M, Seike H, Kubo H, Shimada S. Sarcopenia in patients following stroke: Prevalence and associated factors. Clin Neurol Neurosurg. 2023;233:107910.

Boehme AK, Esenwa C, Elkind MSV. Stroke Risk Factors, Genetics, and Prevention. Circ Res. 2017;120(3):472–95.

Gao Z, Chen H. Advances in the beneficial effects of nutrition on stroke-related Sarcopenia: A narrative review. Medicine (United States). 2023;102(24):e34048.

Leszczak J, Pniak B, Gazda G, Guzik A. Assessment of the effects of rehabilitation of hand function using a biometrics device in people after stroke – a randomized controlled trial. Front Neurol. 2025;16:1–9.

Wang H, Arceo R, Chen S, Ding L, Jia J, Yao J. Effectiveness of interventions to improve hand motor function in individuals with moderate to severe stroke: a systematic review protocol. BMJ Open. 2019;9(9):1–8.

Kumar R, Kaur S, K R. Burden and Coping Strategies in Caregivers of Stroke Survivors. J Neurol Neurosci. 2015;06(s1).

Liu S, Zhang K, Li X, Li C, Peng M. Effects of the different intensities of task-oriented training on the upper extremity motor function and self-care ability of stroke survivors: study protocol for a multiarm parallel-group randomized controlled trial in a tertiary hospital in China. BMJ Open. 2023;13(12). doi:10.1136/bmjopen-2023-074106 PubMed PMID: 38070930.

Bosch J, O’Donnell MJ, Barreca S, Thabane L, Wishart L. Does Task-Oriented Practice Improve Upper Extremity Motor Recovery after Stroke? A Systematic Review. ISRN Stroke. 2014;2014:1–10.

Almhdawi KA, Mathiowetz VG, White M, delMas RC. Efficacy of Occupational Therapy Task-oriented Approach in Upper Extremity Post-stroke Rehabilitation. Occup Ther Int. 2016;23(4):444–56.

Cao J, Hu P, Li L, Dai F, Jin Y. Improving Post-Stroke Cognitive Impairment via Cognitive and Motor Dual Task Gait Training: Potential Mechanisms and Clinical Value. Neuropsychiatr Dis Treat. 2025;21:2559–73.

Wilkins KB, Owen M, Ingo C, Carmona C, Dewald JPA, Yao J. Neural plasticity in moderate to severe chronic stroke following a device-assisted task-specific arm/hand intervention. Front Neurol. 2017;8(6):284.

Aderinto N, AbdulBasit MO, Olatunji G, Adejumo T. Exploring the transformative influence of neuroplasticity on stroke rehabilitation: a narrative review of current evidence. Annals of Medicine and Surgery. 2023;85(9):4425.

Pongtham P, Chingchit W, Dhippayom JP. Improving upper extremity function in chronic stroke using occupational therapy task-oriented approach. Journal of Associated Medical Sciences. 2022;55(1):52–9.

Ballester BR, Maier M, Duff A, Cameirão M, Bermúdez S, Duarte E, et al. A critical time window for recovery extends beyond one-year post-stroke. J Neurophysiol. 2019;122(1):350–7.

Mulhern M. Cognitive Rehabilitation Interventions for Post-Stroke Populations. Dela J Public Health. 2023;9(3):70–4.

Kim S, Cho S. The Effect of Cognitive Rehabilitation Program Combined with Physical Exercise on Cognitive Function, Depression, and Sleep in Chronic Stroke Patients. Physical Therapy Rehabilitation Science. 2022;11(1):32–42.

Bertoni D, Bruni S, Saviola D, De Tanti A, Costantino C. The Role of Cognitive Reserve in Post-Stroke Rehabilitation Outcomes: A Systematic Review. Brain Sci. 2024;14(11):1144.

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Published

2026-08-30

How to Cite

1.
Kurniawan FD, Sumardi N, Tanuwidjaja D, Biben V. Functional Recovery in a Geriatric Woman with Late-Subacute Stroke and Vascular Dementia: A Case Report. J. Med. Health [Internet]. 2026Aug.30 [cited 2026Sep.3];8(2):191-6. Available from: http://114.7.153.31/index.php/jmh/article/view/11889

Issue

Vol. 8 No. 2 (2026)

Section

Articles

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Copyright (c) 2026 Ferdinand D Kurniawan, Novitri Sumardi, Deta Tanuwidjaja, Vitriana Biben

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