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Altered biomechanics is defined as the acquired alteration in the mechanics of the musculoskeletal system that leads to improper movement patterns. Hemiplegia is the reduction in strength or paralysis of one side of the body due to a stroke. The amount of involvement post stroke depends on the site of the lesion. There are various other neurological complications and associated symptoms, but the effect on biomechanics is due to alterations in the muscle strength of the unaffected side of stroke along with hemiplegia or paresis of the affected side. The unaffected side of stroke is considered to be the normal side and is thus not considered in the treatment session, allowing it to lose its competencies, thus, the gait pattern is altered in poststroke survivors. To find the pertinent literature, electronic databases were searched using the terms “biomechanics” and “hemiplegia”. The resulting articles were reviewed, the bibliography was double-checked, and pertinent literature was added. This review article discusses the alterations in the biomechanics of the normal side and the impact on rehabilitation of patients with hemiplegia. It also provides a newer outlook to focus also on the normal side while rehabilitation, thus enhancing early recovery.

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Astrocytomas are one of the most common primary tumours of central nervous system seen in paediatric population. Although it is treatable and has a good prognosis, some individuals suffer from motor dysfunction following brain tumour resection which could result in decreased mobility, difficulty with daily tasks, increased risk of immobility-related problems, falls, pain, anxiety/depression. Thus, having a negative impact on overall quality of life and functional independence. Comprehensive neurophysiotherapy in such cases play a critical role in preventing and alleviating motor dysfunction, and its effects, and improve functional independence. This is the report of a 10-year-old female with astrocytoma in the right frontoparietal lobe, which was diagnosed using magnetic resonance imaging and immunohistochemistry. She underwent craniotomy for the same. But after tumour resection, she developed left hemiplegia wherein involvement of upper limb was more as compared to lower limb. She was given neurophysiotherapy and Accelerated Skill Acquisition Programme (ASAP) which aided in improving upper extremity motor function and functional independence.

Ischaemic stroke is caused by a sudden decrease in blood flow to the areas of the brain that leads to severe impairment if left untreated. The impairments include contralateral loss of motor and sensory functions, along with affection on the ipsilateral side. There is a reduction in strength on the unaffected side of stroke, due to the fact that only 75-90% of corticospinal fibres cross from the medulla to the contralateral side. A 45-year-old male, factory owner came with a chief complaint of sudden onset of weakness on the left side of the body for 11 days with a history of hypertension. Investigations revealed a large block in the right Middle Cerebral Artery (MCA). Medical management was provided with thrombolytics, anticoagulants, and antihypertensives. Thereafter, the patient was referred for physiotherapy. Physiotherapy assessment revealed left hemiplegia with more affection of upper extremity, spasticity grade 1+. He also had reduced gripping and grasping. A tailor-made protocol was formulated which focused on task and approachoriented training with bimanual activities along with consideration of the less affected side was provided to the patient helped in early recovery and made him go back to his occupation. There are many studies on hand rehabilitation, but this is one in its kind that will add to the available literature on the positive effects of strength training on the unaffected side to be considered in rehabilitation.