200 Section - Considerations for inpatient stroke rehabilitation in a 65-year-old patient with osteogenesis imperfecta

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

AF

Anya Friesen, MD

Resident
University of Ottawa
Ottawa, Ontario, Canada
JC

Jacqueline Cochrane, BSc (Hons), MBBS (Hons), FRCPC

Assistant Professor / Stroke Physiatrist
University of Ottawa / Bruyère Health
Ottawa, Ontario, Canada

Case Diagnosis: A 65-year-old woman with type II osteogenesis imperfecta (OI) with an ischemic stroke involving the left corona radiata extending to the posterior limb of the left internal capsule. She had right-sided hemiplegia with more proximal weakness. After eight days, she was admitted to an inpatient stroke rehabilitation unit.

Case Description: At baseline she had been independent with a walker for ambulation and activities of daily living (ADLs). On admission, she required assistance for ADLs and transfers and could not ambulate safely. She worked with a multidisciplinary team including physiotherapy and occupational therapy on strengthening and gait training for 7 weeks. Fear of falling and sustaining fractures limited her engagement with transfer training. She expressed concern that some staff had limited knowledge of OI. Education was provided to the team about the features of OI that might impact her stroke rehabilitation. Modifications were made to her exercise program and fall prevention training was completed. At discharge, she was independent with a walker for transfers and ambulation and required a mix of supervision/assistance for her ADLs.

Discussions: Fear of fractures and lack of healthcare provider knowledge about OI have been common themes in several qualitative studies examining the impact of OI. In this case, we were able to observe the impact of these concerns on this patient’s participation in an inpatient stroke rehabilitation program. Addressing these concerns allowed the team to understand how her OI might impact her rehabilitation course and make appropriate modifications to encourage her full participation.

Conclusions: Participation in an inpatient stroke rehabilitation program helped this patient with OI improve her functional independence post-stroke. A multidisciplinary fall prevention huddle to identify equipment and procedures to reduce fall risk and education of staff about OI were helpful tools in managing the patient's fears related to her OI.