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改善小脑共济失调患者稳定性和步态的物理治疗康复方法:一例报告

Physiotherapy Rehabilitation Approach for Enhancing Stability and Gait in a Patient With Cerebellar Ataxia: A Case Report.

作者信息

Thote Devashish, Yadav Vaishnavi, Bhusari Nikita, Daf Ritik, Agrawal Ishika, Bhoyar Sarang

机构信息

Department of Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Oct 6;16(10):e70967. doi: 10.7759/cureus.70967. eCollection 2024 Oct.

Abstract

Brainstem encephalitis (BE), a rare and potentially fatal condition, can lead to significant neurological impairments, including cerebellar ataxia. This case report describes a 23-year-old female who presented with weakness in both upper and lower limbs, seizures, and an ataxic gait pattern following a history of sepsis-related brainstem encephalitis. Magnetic resonance imaging (MRI) revealed gross cerebellar atrophy. The patient underwent a comprehensive, goal-oriented physiotherapy protocol targeting functional mobility, strength, balance, and coordination. Interventions included task-specific exercises, resistance training, gait training, and coordination drills. Post-intervention assessments showed notable improvements in muscle tone, deep tendon reflexes, and outcome measures such as the Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Scale, and Functional Independence Measure (FIM). This case highlights the importance of early and targeted physiotherapy in managing cerebellar ataxia, demonstrating significant functional recovery and improved quality of life. The findings support the critical role of specialized rehabilitation programs in the comprehensive care of patients with cerebellar ataxia following brainstem encephalitis.

摘要

脑干脑炎(BE)是一种罕见且可能致命的疾病,可导致严重的神经功能障碍,包括小脑共济失调。本病例报告描述了一名23岁女性,在经历与败血症相关的脑干脑炎后,出现双上肢和双下肢无力、癫痫发作以及共济失调步态。磁共振成像(MRI)显示小脑明显萎缩。该患者接受了一项全面的、以目标为导向的物理治疗方案,针对功能活动能力、力量、平衡和协调能力进行训练。干预措施包括特定任务练习、阻力训练、步态训练和协调训练。干预后评估显示,肌张力、深腱反射以及诸如共济失调评估与分级量表(SARA)、伯格平衡量表和功能独立性测量(FIM)等结果指标有显著改善。本病例强调了早期针对性物理治疗在管理小脑共济失调中的重要性,显示出显著的功能恢复和生活质量改善。这些发现支持了专门康复计划在脑干脑炎后小脑共济失调患者综合护理中的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c623/11538478/dc95f284cd94/cureus-0016-00000070967-i01.jpg

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