scholarly journals Long-Term Locomotor Training for Gait and Balance in a Patient With Mixed Progressive Supranuclear Palsy and Corticobasal Degeneration

2007 ◽  
Vol 87 (8) ◽  
pp. 1078-1087 ◽  
Author(s):  
Teresa M Steffen ◽  
Bradley F Boeve ◽  
Louise A Mollinger-Riemann ◽  
Cheryl M Petersen
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Progressive Supranuclear Palsy ◽  
Exercise Program ◽  
Corticobasal Degeneration ◽  
Exercise Group ◽  
Walking Ability ◽  
Locomotor Training ◽  
Impaired Balance

Background and Purpose: Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are slowly progressive tauopathies characterized by impaired balance, disturbances in gait, and frequent falls, among other features. Wheelchair dependence is an inevitable outcome in people with these disorders. Insufficient evidence exists regarding the effectiveness of exercise in the management of people with these disorders. This case report describes a program of exercise and long-term locomotor training, using a treadmill (both with and without body-weight support), to reduce falls and improve the balance and walking ability of a patient with mixed PSP and CBD features. Case Description: Six years after diagnosis with mixed PSP and CBD features, the client, a 72-year-old dentist, was seen for physical therapy for asymmetric limb apraxia, markedly impaired balance, and frequent falls during transitional movements. Intervention: Over a 2.5-year period, intervention included routine participation in an exercise group for people with Parkinson disease (mat exercise and treadmill training) and intermittent participation in individual locomotor training on a treadmill. The exercise group met for 1 hour, twice weekly. The individual treadmill sessions lasted 1 hour, once weekly, for two 14-week periods during the follow-up period. Outcomes: Over the 2.5-year period, fall frequency decreased, and tests of functional balance showed improved limits of stability (functional reach tests) and maintained balance function (Berg Balance Scale). Tests of walking performance showed only slight declines. A 4-wheeled walker was introduced and accepted by the client early in the intervention period. The client, with supervision, remained ambulatory with this wheeled walker in the community. Discussion: In this case report of a person with mixed PSP and CBD features, a physical therapy intervention, which included locomotor training using a treadmill and a long-term exercise program of stretching and strengthening, appears to have improved some dimensions of balance, slowed the rate of gait decline, prevented progression to wheelchair dependence, and decreased falls. Contrary to the expected decline in function, this client maintained independent mobility over a 2.5-year period. An ongoing, intensive program of exercise and locomotor training may help people with PSP and CBD maintain upright balance, decrease falls, and decrease the rate of decline of ambulation.

scholarly journals Long-Term Exercise Training for an Individual With Mixed Corticobasal Degeneration and Progressive Supranuclear Palsy Features: 10-Year Case Report Follow-up

2014 ◽  
Vol 94 (2) ◽  
pp. 289-296 ◽  
Author(s):  
Teresa M. Steffen ◽  
Bradley F. Boeve ◽  
Cheryl M. Petersen ◽  
Leah Dvorak ◽  
Kejal Kantarci
Keyword(s):  
Case Report ◽  
Progressive Supranuclear Palsy ◽  
Gait Speed ◽  
Slow Rate ◽  
Brain Volume ◽  
Exercise Program ◽  
Corticobasal Degeneration ◽  
Volume Loss ◽  
Brain Volume Loss

Background and PurposeThis case report describes the effects of long-term (10-year) participation in a community exercise program for a client with mixed features of corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP). The effects of exercise participation on both functional status and brain volume are described.Case DescriptionA 60-year-old male dentist initially reported changes in gait and limb coordination. He received a diagnosis of atypical CBD at age 66 years; PSP was added at age 72 years. At age 70 years, the client began a therapist-led community group exercise program for people with Parkinson disease (PD). The program included trunk and lower extremity stretching and strengthening, upright balance and strengthening, and both forward and backward treadmill walking. The client participated twice weekly for 1 hour for 10 years and was reassessed in years 9 to 10.OutcomesFalls (self-reported weekly over the 10-year period of the study by the client and his wife) decreased from 1.9 falls per month in year 1 to 0.3 falls per month in year 10. Balance, walking endurance, and general mobility declined slightly. Gait speed (both comfortable and fast) declined; the client was unable to vary gait speed. Quantitative brain measurements indicated a slow rate of whole brain volume loss and ventricular expansion compared with clients with autopsy-proven CBD or PSP.DiscussionThis client has participated consistently in a regular group exercise program for 10 years. He has reduced fall frequency, maintained balance and endurance, and retained community ambulation using a walker. Combined with the slow rate of brain volume loss, this evidence supports the efficacy of a regular exercise program to prolong longevity and maintain function in people with CBD or PSP.

scholarly journals Supported Treadmill Training for Gait and Balance in a Patient With Progressive Supranuclear Palsy

2002 ◽  
Vol 82 (5) ◽  
pp. 485-495 ◽  
Author(s):  
Monthaporn Suteerawattananon ◽  
Betty MacNeill ◽  
Elizabeth J Protas
Keyword(s):  
Body Weight ◽  
Case Report ◽  
Physical Therapy ◽  
Progressive Supranuclear Palsy ◽  
Treadmill Training ◽  
Body Weight Support ◽  
Program Outcomes ◽  
Weight Support ◽  
Patient Reported ◽  
Impaired Balance

Abstract Background and Purpose. Impaired balance, gait disturbances, and frequent falls are common problems in people with progressive supranuclear palsy (PSP). This case report describes the use of a modified body weight support treadmill training program to reduce falls and improve the balance and gait of a patient with PSP. Case Description. The patient was a 62-year-old man diagnosed with PSP. His major problems were impaired balance and frequent, abrupt falls. Methods. Physical therapy included walk training, balance perturbation, and step training using body weight support with a treadmill. Training sessions lasted 11/2 hours and occurred 3 days a week for 8 weeks. Fall incidence, balance, and gait were assessed before, during, and after the program. Outcomes. The patient reported fewer falls during and after training. Balance and gait improved after training. Discussion. This case report is the first to report fall reduction, improved gait, and improved balance following physical therapy for a person with PSP.

scholarly journals Atypical Manifestation of Polyneuropathy in Covid-19

2021 ◽  
Author(s):  
Nayara de Lima Froio ◽  
Ana Luisa Rosas Sarmento ◽  
Sonia Maria Cesar de Azevedo Silva ◽  
Lilia Azzi Collet da Rocha Camargo
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Sore Throat ◽  
Neurological Symptoms ◽  
Lower Limbs ◽  
Neurological Manifestations ◽  
Sensory Motor ◽  
Hands And Feet ◽  
Atypical Manifestation

Context: Neurological manifestations of Sars-CoV-2 are progressively emerging. Cases of Guillain-Barré syndrome and its variants, with onset about 5-10 days after influenza symptoms, have been described. This paper reports a case of polyneuropathy with onset 90 days after a sore throat episode and persistence of IgM positivity in serology for Sars- Cov-2. We aim to raise awareness of this possibility. Case Report: A 56-year-old male, hypertensive, presented with sore throat on April 21, 2020. Serology for Covid-19 was performed with positive IgM. There was complete improvement of the symptom. At the end of July, he started a symmetrical paresthesia in the feet with ascension to the knees and, on August 20, paresthesia in the hands too. So, he went to IAMSPE (SP) and tactile and painful hypoesthesia in hands and feet, hypopalesthesia in lower limbs, a fall in the lower limbs upon Mingazzini’s maneuver, global hyporeflexia and talon gait were found. Just the following tests were changed: second Covid-19 serology IgM and IgG positives; ENMG: sensory motor polyneuropathy, primarily axonal, with signs of chronicity and without signs of acute denervation in the current. Started gabapentin and physical therapy. Patient still has paresthesia in hands and feet, but with partial improvement. Conclusion: This case alerts to neurological symptoms of Covid-19 in the medium and long term.

Cost-utility and cost-effectiveness analyses of a long-term, high-intensity exercise program compared with conventional physical therapy in patients with rheumatoid arthritis

2005 ◽  
Vol 53 (1) ◽  
pp. 39-47 ◽  
Author(s):  
Wilbert B. van den Hout ◽  
Zuzana de Jong ◽  
Marten Munneke ◽  
Johanna M. W. Hazes ◽  
Ferdinand C. Breedveld ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
Physical Therapy ◽  
High Intensity ◽  
Exercise Program ◽  
Cost Utility ◽  
High Intensity Exercise

scholarly journals Effect of quadriceps strengthening exercises alone and in combination with Baduanjin qigong on older adults with knee osteoarthritis: a quasi-experimental study

2020 ◽  
Author(s):  
fenglan wang ◽  
Xiaoli Zhang ◽  
Xiao Tong ◽  
Min Zhang ◽  
Fengmei Xing ◽  
...  
Keyword(s):  
Older Adults ◽  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Physical Function ◽  
Self Efficacy ◽  
Exercise Program ◽  
Exercise Group ◽  
Strengthening Exercises ◽  
Quasi Experimental

Abstract BackgroundExercise is recommended as a core treatment for individuals with KOA. However, the optimal exercise program to promote long-term compliance for KOA patients is not clear. The aim of this study is to compare the effects of the combination exercise program (quadriceps strengthening exercises (QSE) plus Baduanjin qigong) versus QSE alone on older adults with knee osteoarthritis (KOA). MethodsA two-arm, quasi-experimental trial with repeated measurements was used. As a cluster randomized trial, participants from one community center were assigned to combination exercise group while participants from the other center were assigned to QSE group. We assessed pain intensity, physical function, self-efficacy, and HRQoL with standardized instruments at baseline, 3 and 6 months. Results87 participants with KOA who aged above 60 completed the study. Over the 6 months, There were significant time by group interaction effects on pain intensity (F = 44.419, p < 0.001), physical function (F = 46.904, p < 0.001) and self-efficacy (F = 49.754, p < 0.001), as well as in the physical component summary (F = 15.205, p < 0.001) and mental component summary of SF-12 (F = 19.205, p < 0.001), with the combination exercise group exhibiting significantly greater improvements in all outcomes than QSE group. ConclusionsCombination exercise treatment is more effective than QSE for relieving pain, increasing physical functioning, and improving self-efficacy, and quality of life in community-dwelling KOA older adults. Also, it could promote long-term compliance for KOA community patients.Trial registrationChinese Clinical Trails Registry number ChiCTR2000033387 (retrospectively registered). Registered 30 May 2020

Physical Therapy for Spinal Accessory Nerve Injury Complicated by Adhesive Capsulitis

2001 ◽  
Vol 81 (3) ◽  
pp. 936-944 ◽  
Author(s):  
Tadeusz Laska ◽  
Kimberly Hannig
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Nerve Injury ◽  
Adhesive Capsulitis ◽  
Neuromuscular Electrical Stimulation ◽  
Exercise Program ◽  
Spinal Accessory Nerve ◽  
Accessory Nerve ◽  
Left Shoulder ◽  
Spinal Accessory

Abstract Background and Purpose. The authors found no literature describing adhesive capsulitis as a consequence of spinal accessory nerve injury and no exercise program or protocol for patients with spinal accessory nerve injury. The purpose of this case report is to describe the management of a patient with adhesive capsulitis and spinal accessory nerve injury following a carotid endarterectomy. Case Description. The patient was a 67-year-old woman referred for physical therapy following manipulation of the left shoulder and a diagnosis of adhesive capsulitis by her orthopedist. Spinal accessory nerve injury was identified during the initial physical therapy examination, and a program of neuromuscular electrical stimulation was initiated. Outcomes. The patient had almost full restoration of the involved muscle function after 5 months of physical therapy. Discussion. This case report illustrates the importance of accurate diagnosis and suggests physical therapy intervention to manage adhesive capsulitis as a consequence of spinal accessory nerve injury.

scholarly journals Exercise Adherence Following Physical Therapy Intervention in Older Adults With Impaired Balance

2006 ◽  
Vol 86 (3) ◽  
pp. 401-410 ◽  
Author(s):  
Rebecca Forkan ◽  
Breeanna Pumper ◽  
Nicole Smyth ◽  
Hilary Wirkkala ◽  
Marcia A Ciol ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
Fear Of Falling ◽  
Exercise Program ◽  
Exercise Adherence ◽  
Home Exercise ◽  
Exercise Participation ◽  
Impaired Balance ◽  
Therapy Intervention ◽  
Physical Therapy Intervention

Abstract Background and Purpose. This study looked at adherence, and factors affecting adherence, to a prescribed home exercise program (HEP) in older adults with impaired balance following discharge from physical therapy. Subjects. The subjects were 556 older adults (≥65 years of age) who were discharged from physical therapy during the period 2000 to 2003. Methods. A survey was developed to determine participation in a HEP. Univariate logistic regressions identified specific barriers and motivators that were associated with exercise participation following discharge from physical therapy. Results. Ninety percent of respondents reported receiving a HEP; 37% no longer performed it. Change in health status was the primary reason for poor adherence to a HEP. Eight barriers (no interest, poor health, weather, depression, weakness, fear of falling, shortness of breath, and low outcomes expectation) were associated with a lack of postdischarge participation in exercise. Discussion and Conclusions. Exercise adherence following discharge from a physical therapy program is poor among older adults. Barriers, not motivators, appear to predict adherence. [Forkan R, Pumper B, Smyth N, et al. Exercise adherence following physical therapy intervention in older adults with impaired balance.

scholarly journals Physiotherapy according to the BeBo Concept as prophylaxis and treatment of urinary incontinence in women after natural childbirth

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aneta Śnieżek ◽  
Dorota Czechowska ◽  
Marta Curyło ◽  
Jacek Głodzik ◽  
Paweł Szymanowski ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Physical Therapy ◽  
Pelvic Floor ◽  
Positive Impact ◽  
Pelvic Floor Muscle ◽  
Exercise Program ◽  
Exercise Group ◽  
Urinary Continence ◽  
Control Group ◽  
Natural Childbirth

AbstractPelvic floor muscle dysfunctions can lead to urinary incontinence, a condition which often affects women both during pregnancy and after childbirth. As a result of this, certain exercises are recommended during and after pregnancy to prevent and treat this incontinence, and the BeBo Concept is one of these methods used to prevent pelvic floor muscle dysfunction. The aim of the present study was to evaluate the effects of a 6-week course of physical therapy according to the BeBo Concept on the improvement of perineal muscle strength and endurance as well as urinary continence in women after their first vaginal delivery. The study was conducted on a group of 56 women who were randomly assigned to the exercise (n = 30) or control (n = 26) group. The exercising group participated in a 6-week physical therapy program according to the BeBo Concept. Pelvic floor muscles were assessed using the perineometer and palpation Perfect Test. UDI6 and ICIQ-SF questionnaires were used to obtain information about the symptoms of urinary incontinence, evaluate the frequency, severity and impact of urine leakage on the quality of life. In all women after natural childbirth, regardless of treatment, it was observed that measured parameters improved, but the improvement was slightly more explicit in those who participated in the Bebo Concept exercise group (e.g. ICIQ-SF exercise group p = 0.001, control group p = 0.035). Due to its positive impact on the pelvic floor, this exercise program should be recommended to women after natural childbirth.

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