Neurosensory and cognitive stimulation in functional recovery after a stroke: a case report
DOI:
https://doi.org/10.37914/riis.v9.550Keywords:
hemorrhagic stroke, neurological rehabilitation, rehabilitation nursing, case reportsAbstract
Background: stroke is one of the leading causes of death and disability, with thalamic hemorrhage associated with severe motor, sensory, and cognitive deficits, compromising the person's autonomy and resulting in a poor prognosis. Comprehensive functional rehabilitation, including neurosensory and cognitive stimulation, is essential for functional recovery and participation in activities of daily living. Objective: to describe the implementation and outcomes of a 16-session rehabilitation nursing program, focusing on neurosensory and cognitive stimulation, in a person with hemorrhagic thalamic stroke. Methodology: case report of an 82-year-old woman, previously independent, admitted to the surgical ward after a hemorrhagic thalamic stroke. Sixteen rehabilitation nursing sessions (15–30 minutes per intervention) were performed, involving multisensory stimulation and functional cognitive training. Progress was monitored using validated instruments. Results: progressive improvement was observed on the Glasgow Coma Scale (9 to 13), NIHSS (28 to 12), Rancho Los Amigos Scale (level II to VI), and MIF (18 to 32), reflecting improvements in cognition and overall functionality. Conclusion: the study suggests potential benefit of structured interventions of neurosensory stimulation, cognitive training, and family involvement for functional recovery in severe hemorrhagic stroke.
References
Abbate, C., Trimarchi, P. D., Basile, I., Mazzucchi, A., & Devalle, G. (2014). Sensory stimulation for patients with disorders of consciousness: from stimulation to rehabilitation. Frontiers in Human Neuroscience, 8, 616. https://doi.org/10.3389/fnhum.2014.00616
Barbosa, B. G., Rocha, B. O., Neto, M. L. S., & Boffino, C. C. (2024). Processo de plasticidade neuronal pós acidente vascular encefálico: revisão sistemática. Revista de Epidemiologia e Saúde Pública, 2(3). https://doi.org/10.59788/resp.v2i3.84
Bayley, M. T., Janzen, S., Harnett, A., Teasell, R., Patsakos, E., Marshall, S., Bragge, P., Velikonja, D., Kua, A., Douglas, J., Togher, L., Ponsford, J., & McIntyre, A. (2023). INCOG 2.0 Guidelines for cognitive rehabilitation following traumatic brain injury: methods, overview, and principles. The Journal of Head Trauma Rehabilitation, 38(1), 7–23. https://doi.org/10.1097/HTR.0000000000000838
Cicerone, K. D., Goldin, Y., Ganci, K., Rosenbaum, A., Wethe, J. V., Langenbahn, D. M., Malec, J. F., Bergquist, T. F., Kingsley, K., Nagele, D., Trexler, L., Fraas, M., Bogdanova, Y., & Harley, J. P. (2019). Evidence-based cognitive rehabilitation: systematic review of the literature from 2009 through 2014. Archives of Physical Medicine and Rehabilitation, 100(8), 1515–1533. https://doi.org/10.1016/j.apmr.2019.02.011
Costa, J., Vale, J., & Castro-Caldas, A. (2011). Estado neurológico, cognição e reabilitação após AVC. Revista da Escola de Enfermagem da USP, 45 (5), 1083-1088. https://doi.org/10.1590/S0080-62342011000500008
Direção-Geral da Saúde. (2017). Programa nacional para as doenças cérebro-cardiovasculares. https://www.ulssjose.min-saude.pt/wp-content/uploads/sites/3/2017/10/DGS_PNDCCV_VF.pdf
Figueiredo, A., Pereira, A. & Mateus, S. (2020). Acidente vascular cerebral isquémico versus hemorrágico: taxas de sobrevivência. HIGEIA - Revista Científica da Escola Superior de Saúde Dr. Lopes Dias, 3(1), 35-45. http://hdl.handle.net/10400.11/7144
Galdeano, L. E., Rossi, L. A., & Zago, M. M. F. (2003). Roteiro instrucional para a elaboração de um estudo de caso clínico. Revista Latino-Americana de Enfermagem, 11(3), 371–375. https://doi.org/10.1590/S0104-11692003000300016
Guidelines to writing a clinical case report. (2017). Heart Views, 18(3), 104–105. https://doi.org/10.4103/1995-705X.217857
Jeffay, E., Ponsford, J., Harnett, A., Janzen, S., Patsakos, E., Douglas, J., Kennedy, M., Kua, A., Teasell, R., Welch-West, P., Bayley, M., & Green, R. (2023). INCOG 2.0 Guidelines for cognitive rehabilitation following traumatic brain injury, part iii: executive functions. The Journal of Head Trauma Rehabilitation, 38(1), 52–64. https://doi.org/10.1097/HTR.0000000000000834
Johansson, B. B. (2000). Brain plasticity and stroke rehabilitation. Stroke, 31(1), 223–230. https://doi.org/10.1161/01.str.31.1.223
Johansson, B. B. (2012). Multisensory stimulation in stroke rehabilitation. Frontiers in Human Neuroscience, 6. https://doi.org/10.3389/fnhum.2012.00060
Laste, A., Storch, L., Raffo, G., Garcez, L., Guimarães, L., de Oliveira, G., Melo, P., Maurer, A., Froncheti, H., Brum, P., Wermann, H., Gropelli, F., Moreira, T., Bernardino, P., & Seadi, R. (2024). Neuroplasticidade e reabilitação neurológica. In G. B. L. de Freitas (Ed.), Neurologia: diagnósticos, tratamentos e cirurgias (Ed. V, pp. 51-63). Editora Pasteur. https://doi.org/10.59290/978-65-6029-171-3.7
Lee, S.-H., Park, K.-J., Kang, S.-H., Jung, Y.-G., Park, J.-Y., & Park, D.-H. (2015). Prognostic factors of clinical outcomes in patients with spontaneous thalamic hemorrhage. Medical Science Monitor, 21, 2638–2646. https://doi.org/10.12659/MSM.894132
Lima, M. (2024). Neuroplasticidade e reabilitação neurológica. Lidel.
Menon, G., Hegde, A., Kongwad, L. I., & Omkarappa, S. (2019). Primary thalamic haemorrhage – clinical profile and prognostic predictors from a series of 117 cases. The Open Neurology Journal, 13, 76-82. https://doi.org/10.2174/1874205X01913010076
Mulhern, M. (2023). Cognitive rehabilitation interventions for post-stroke populations. Delaware Journal of Public Health, 9 (3), 70-74. https://doi.org/10.32481/djph.2023.08.012
National Institute of Neurological Disorders and Stroke. (2025). NIH Stroke Scale. https://www.ninds.nih.gov/health-information/stroke/assess-and-treat/nih-stroke-scale
O’Donoghue, M., Leahy, S., Boland, P., Galvin, R., McManus, J., & Hayes, S. (2022). Rehabilitation of cognitive deficits poststroke: systematic review and meta-analysis of randomized controlled trials. Stroke, 53(5), 1700–1710. https://doi.org/10.1161/STROKEAHA.121.034218
Ordem dos Enfermeiros. (2016). Instrumentos de recolha de dados para a documentação dos cuidados especializados em enfermagem de reabilitação. https://www.ordemenfermeiros.pt/arquivo/colegios/Documents/2017/InstRecolhaDadosDocumentacaoCuidEnfReabilitacao_Final_2017.pdf
Ordem dos Enfermeiros. (2019). Regulamento das competências específicas do enfermeiro em enfermagem de reabilitação. https://www.ordemenfermeiros.pt/media/11871/1356513568.pdf
Organisation for Economic Co-operation and Development, & European Observatory on Health Systems and Policies. (2025). State of health in the EU: Portugal. Country health profile 2025. https://eurohealthobservatory.who.int/publications/m/portugal-country-health-profile-2025
Parisi, A., Bellinzona, F., Di Lernia, D., Repetto, C., de Gaspari, S., Brizzi, G., Riva, G., & Tuena, C. (2022). Efficacy of multisensory technology in post-stroke cognitive rehabilitation: a systematic review. Journal of Clinical Medicine, 11(21), 6324. https://doi.org/10.3390/jcm11216324
Pereira, V. J. R., Ribeiro, A. R. P., Coelho, P. C. G., & Morgado, T. M. M. (2021). Tradução e adaptação transcultural da Rancho Los Amigos Levels of Cognitive Functioning Scale para português europeu. Revista Portuguesa de Enfermagem de Reabilitação, 4(2), 38–46. https://doi.org/10.33194/rper.2021.174
Reddin, C., Judge, C., Loughlin, E., Murphy, R., Costello, M., Alvarez, A., Ferguson, J., Smyth, A., Canavan, M., & O’Donnell, M. J. (2021). Association of oral anticoagulation with stroke in atrial fibrillation or heart failure: a comparative meta-analysis. Stroke, 52(10), 3151–3162. https://doi.org/10.1161/STROKEAHA.120.033910
Riley, D. S., Barber, M. S., Kienle, G. S., Aronson, J. K., Von Schoen-Angerer, T., Tugwell, P., Kiene, H., Helfand, M., Altman, D. G., Sox, H., Werthmann, P. G., Moher, D., Rison, R. A., Shamseer, L., Koch, C. A., Sun, G. H., Hanaway, P., Sudak, N. L., Kaszkin-Bettag, M., … Gagnier, J. J. (2017). CARE guidelines for case reports: explanation and elaboration document. Journal of Clinical Epidemiology, 89, 218–235. https://doi.org/10.1016/j.jclinepi.2017.04.026
Teasdale, G. (2015). Glasgow coma scale: assessment aid. https://www.glasgowcomascale.org/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Inês Agostinho, Ana Rosa, Verónica Afonso, Ricardo Cunha, José Magalhães
This work is licensed under a Creative Commons Attribution 4.0 International License.
