A Patient with Inclusion Body Myositis suffering from Left Thalamic Hemorrhage

We report a case of a 74-year-old man with dual disabilities. The patient suffered from inclusion body myositis for 13 years, and then suddenly developed right hemiplegia due to a left thalamic hemorrhage, and was transferred to our department for further rehabilitation after undergoing conservative treatment at the acute stage. Although his hemiplegia considerably improved at admission(Brunnstrom stage V/V), he experienced a severe disturbance when standing up and walking because of muscle weakness in the pelvic girdle and upper thighs, and sensory disturbance in his right lower extremity, and therefore had to wear a waist belt for assistance during standing up and a plastic Ankle Foot Orthosis(AFO)with a solid ankle on the right side for stability during walking. To improve his impairment, he underwent muscle strengthening training for the pelvic girdle and lower extremities as much as an ordinary hemiplegic patient, and his muscle strength increased without any muscle pain or blood CK rise. After 12 weeks of the training, he could stand up and walk independently 80m with a tripod cane and AFO, requiring no assistance. In conclusion, this patient with dual disabilities was able to improve his ability to stand up and walk in spite of mild hemiplegia, and the muscle strengthening training he underwent was not harmful even though the patient also suffered from inclusion body myositis.