Miller Nancy H, Miller David J, Goldberg Joanna L
Department of Pediatrics, Baystate Medical Center, Springfield, MA, USA.
Phys Ther. 2006 Jun;86(6):843-56.
The incidence of West Nile virus (WNV) has increased in the United States since 1999. A small percentage of people with WNV develop West Nile neuroinvasive disease (WNND) with encephalitis and flaccid paralysis. The purpose of this report is to describe the physical therapist management and outcomes for a patient with WNND and the therapist's efforts to use an evidence-based practice approach in the management of a patient with this disease.
The patient was an active 55-year-old woman in excellent health who became acutely ill with asymmetrical lower-extremity weakness. The physical therapist reviewed the available literature, consulted with medical and physical therapist experts and the patient, and elected to use a poliovirus "period of recovery" approach combining intensive strengthening and monitoring of fatigue.
The patient progressed from an initial nonambulatory status to ambulation with a single-point cane at week 18 after onset of symptoms. She began to ambulate without an assistive device by week 20. The patient returned to work part-time by week 22 and full-time by week 43.
These outcomes demonstrate the recovery of a patient with WNND after an intensive strengthening program.
自1999年以来，西尼罗河病毒（WNV）在美国的发病率有所上升。一小部分感染WNV的人会发展为伴有脑炎和弛缓性麻痹的西尼罗河神经侵袭性疾病（WNND）。本报告的目的是描述一名WNND患者的物理治疗师管理及治疗结果，以及治疗师在管理该疾病患者时采用循证实践方法所做的努力。
患者是一名55岁的活跃女性，身体健康状况良好，突然出现不对称性下肢无力。物理治疗师查阅了现有文献，咨询了医学和物理治疗专家以及患者，并选择采用脊髓灰质炎病毒“恢复期”方法，结合强化肌力训练和疲劳监测。
患者从最初无法行走的状态进展到症状出现后第18周可使用单拐行走。到第20周时，她开始无需辅助器械行走。患者在第22周恢复兼职工作，第43周恢复全职工作。
这些结果表明，强化肌力训练计划后，一名WNND患者实现了康复。
