Affiliations 

  • 1 Universiti Malaysia Sabah
  • 2 Queen Elizabeth Hospital (Malaysia)
MyJurnal

Abstract

Introduction:Stroke is a major public health concern and treating its complications is important for functional recov-ery. Heterotopic ossification (HO), a condition where bone is developed in non-skeletal tissue, is not an uncommon stroke-related complication with reported occurrence up to 12%. It typically presents with joint range of motion (ROM) limitation, pain and swelling. Detecting HO is important to prevent forceful joint manipulation during reha-bilitation that can cause pain and fracture. Two cases of diagnosing HO during the course of stroke rehabilitation are presented. Case description: First case was a subacute stroke in 25 year-old male with right-sided hemiparesis and right hip joint ROM limitation. He did not consent to have passive ROM exercise and refused to be seated due to severe right hip pain. Second case was a 41 year-old male with chronic right-sided hemiparetic stroke exhibiting ipsilateral lower limb neurological recovery but inability to perform bed mobility and walking despite regaining motor function. The right hip joint ROM was limited in the absence of pain. Radiographs demonstrated presence of HO in the affected hip of both patients. Gentle hip ROM exercise was prescribed and noted improvement in ROM with subsequent ability for sitting (first case) and short-distance ambulation (second case). Conclusion: HO should be considered as a differential diagnosis in stroke patients having limited ROM, hence the importance of thorough physical examination. Presence of HO would guide rehabilitation process by encouraging gentle ROM exercise in the attempt to reduce public health burden from halted functional recovery in stroke.