Multimodal Ayurvedic and Rehabilitation Approach in Chronic Post-stroke Hemiplegia (Pakshaghata): A Case Report

Abstract

Introduction: Stroke is a leading cause of long-term disability, with hemiplegia significantly impacting quality of life. This condition correlates with Pakshaghata, a Vata-dominant disorder in Ayurveda. This report evaluates a comprehensive Ayurvedic management protocol for chronic post-stroke hemiplegia. Case Presentation: A 66-year-old male with right-sided hemiplegia and slurred speech for two years following an ischemic stroke presented with muscle power of 2/5 in right limbs (MRC grade), spasticity, and inability to walk. Comorbidities included hypertension and ischemic heart disease s/p CABG. Intervention: A 17-day inpatient protocol included: Sthanik Lepa, Koshtha Shodhana, Udvartana, Parisheka, Sarvanga Abhyanga (with Mahanarayana and Balaashvagandhadi Taila), Jambeera Pinda Sweda, Shashtika Shali Pinda Sweda, and Shiropichu. Basti therapy comprised 10 Anuvasana and 6 Niruha Basti with Sahacharadi Taila and Mamsa Rasa. Shamana medications and physiotherapy were concurrently administered. Outcome: Post-treatment, right upper limb power improved to 3/5 and lower limb to 4/5. Hypertonicity reduced, sitting balance improved, and the patient achieved ambulation with support. Fall tendency resolved completely. Barthel Index scores showed enhanced functional independence. No adverse events occurred. Discussion: The phase-wise approach addressed both Margavarana and Dhatukshaya. Basti therapy regulated Vata, while Shashtika Shali Pinda Sweda provided Brimhana effects. Physiotherapy synergistically enhanced neuromuscular recovery. Conclusion: Structured Ayurvedic intervention can achieve meaningful functional recovery in chronic post-stroke hemiplegia, even two years post-insult, offering a safe adjunctive approach when conventional treatments plateau.