There are almost 800,000 stroke survivors each year in the United States (Mozaffarian et al., 2015). One of the most severe types of stroke is locked- in syndrome (LIS) due to the loss of almost all functions and a high mortality rate (Casanova, Lazzari, Lotta, & Mazzucchi, 2003; Hoyer, Normann, Sorsdal, & Strand, 2010). The prevalence of LIS is unknown, but is estimated in the tens of thousands. The majority of the literature regarding locked- in syndrome is based on case reports that utilized multidisciplinary interventions focused mostly on improving functional communication and respiratory care with minimal focus on motor retraining (Beaudoin & Serres, 2010; Leon- Carrion, van Eckhout, & Dominguez- Morales, 2002; Schjolberg & Sunnerhagen, 2012). These reports were neither dynamic nor multi-sensory, and the only technology utilized was in the form of augmentative communication (Leon- Carrion et al., 2002). There are types of technology frequently used in the general stroke population that have similar motor deficits as the LIS population. This case report explains an interdisciplinary approach using motor and communication interventions that are multisensory, progressive, multi-modal, and technology- based for a stroke survivor with LIS. The LOS was 153 days in acute rehabilitation, which is longer than average. However the patient did return home, making significant gains in overall function. The Functional Independence Measure (FIM) was the outcome measure used. In this patient, the changes in motor (gain of 42 points), cognitive (gain of 29 points) and total score (gain of 71 points) surpassed what was determined to be a minimal clinically important difference (Beninato et al., 2006). These results suggest that this treatment program and approach may be a key reason why this patient was able to achieve significant functional gains and report improved quality of life.
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