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【論文摘要】Effects of Activity-Based Therapy on Functional Recovery for the Patient With Transverse Myelitis: A Case Report

【論文摘要】活動本位治療對橫截性脊髓炎病人功能恢復之成效:個案報告

摘要


Background and Purpose: Transverse myelitis is an acute or subacute course of spinal cord disorder and non-compressive myelopathy. Patient with transverse myelitis will usually be presented clinically by pyramidal signs (muscle weakness or paralysis, spasticity, hyperreflexia), sensory impairment, and autonomic dysfunction. Rehabilitation is needed in order to regain the lost functional ability caused by the impairments. Activity-based therapy (ABT) uses neurorestorative theory attempting to activate muscles below the level of the lesion, whereas conventional rehabilitation uses preserved muscles to achieve compensatory functioning. According to the previous study, ABT was proven to effectively promote neurological recovery, such as lower extremity motor score (LEMS), gait speed, walking endurance, gait symmetry, standing balance, and overall functional ambulatory capacity. The purpose of this report was to evaluate the effects of ABT as a rehabilitation intervention on functional recovery in patient with transverse myelitis. Methods: Physical examination of a 59-year-old female with transverse myelitis (from C3 to conus medullaris) were showed muscle weakness from L2 to S1 with the range of manual muscle testing (MMT) grade from 2 to 3+, insufficient dynamic standing balance, insufficient ambulation ability and endurance. She received ABT intervention twice a week for 4 weeks. The outcomes were tested before and after the intervention through LEMS, 10-m walk test, Timed Up and Go (TUG) test, 6-min walk test. Results: The patient's LEMS increased from 23 to 36. Dynamic standing balance improved from good to normal. In the 10-m walk test improved from 0.77 to 1.11 m/sec. The patient's TUG test decreased from 26 to 15 sec. She is now able to go up and down stairs with handrail. The improvement in physical endurance was also noted from 6-min walk test from 200 to 290 m. Conclusion: ABT therapy is effective for improving patient’s functional ability, including muscle strength, dynamic standing balance, ambulation ability, and physical endurance. Clinical Relevance: Our results provide important information to help with the design of intervention program for patient with transverse myelitis in Taiwan.

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