Białkowska Joanna, Mroczkowska Dorota, Huflejt Margaret E, Wojtkiewicz Joanna, Siwek Tomasz, Barczewska Monika, Maksymowicz Wojciech
1Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 2Clinical University Hospital, Olsztyn, Poland; 3Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 4Department of Neurology and Neurosurgery, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland.
Acta Clin Croat. 2019 Dec;58(4):757-766. doi: 10.20471/acc.2019.58.04.24.
Amyotrophic lateral sclerosis is a progressive and fatal degenerative neuromuscular disease with few if any treatment options and physical rehabilitation addressing specific deficits is the most frequent form of therapy. Patients also suffer from depression and increased anxiety. Our purpose was to assess the neurorehabilitation effectiveness in a patient with amyotrophic lateral sclerosis who underwent stem cell transplantation but refused physiotherapy due to depression. Disease progression was followed using the revised Amyotrophic Lateral Sclerosis Functional Rating Scale bimonthly for six months pre- and then post-stem cell transplantation. Psychological traits were assessed using six standardized tests. Quantitative electroencephalogram diagnostics was performed before the first and after the last neurofeedback session, and sessions were conducted on a 3-times-a-week basis. The physiotherapy protocol included proprioceptive neuromuscular facilitation, electrical modalities unit applied to the lumbar spine area, and breathing, relaxation and walking exercises, among others. Increased motivation and marked decrease in the pain level was associated with the patient's willingness to complete physiotherapy, which resulted in improvements in most neuromuscular deficits and in increased respiratory capacity. During the 12 post-rehabilitation months, progression of the disease decelerated, and a positive behavioral change was noted. The study suggested that neurofeedback could be used as a neurorehabilitation component of the personalized complex rehabilitation protocol in patients with amyotrophic lateral sclerosis.
肌萎缩侧索硬化症是一种进行性且致命的退行性神经肌肉疾病，几乎没有治疗选择，针对特定缺陷的物理康复是最常见的治疗形式。患者还会遭受抑郁和焦虑加剧的困扰。我们的目的是评估一名接受干细胞移植但因抑郁而拒绝物理治疗的肌萎缩侧索硬化症患者的神经康复效果。在干细胞移植前后六个月，每两个月使用修订版肌萎缩侧索硬化症功能评定量表跟踪疾病进展。使用六项标准化测试评估心理特征。在第一次神经反馈治疗前和最后一次神经反馈治疗后进行定量脑电图诊断，治疗每周进行三次。物理治疗方案包括本体感觉神经肌肉促进法、应用于腰椎区域的电疗法设备以及呼吸、放松和步行练习等。动机增强和疼痛水平显著降低与患者完成物理治疗的意愿相关，这导致大多数神经肌肉缺陷得到改善且呼吸能力增强。在康复后的12个月里，疾病进展减缓，并且观察到了积极的行为变化。该研究表明，神经反馈可作为肌萎缩侧索硬化症患者个性化综合康复方案的神经康复组成部分。
