Is Perturbation-based Balance Training an Effective Treatment for Patients with Alcoholic Neuropathy?

Abstract

Background/Purpose: Patients can develop peripheral neuropathies from a variety of causes: diabetes, poor circulation, cancer treatment, and in this case alcoholism. Peripheral neuropathy is a condition, and a risk factor for increased risk of falls, poor balance, movement disorders, and subsequently sedentary behavior lending to a cascade of problems. It is not clear whether perturbation balance training is effective in reducing fall risk of individuals in the acute care setting with neuropathies due to alcoholism. Case Discussion: A 47 year old homeless male was admitted to the hospital on 11/02/15 with symptoms of end stage liver disease, malnutrition, and alcohol dependence. The patient presented to Physical Therapy (PT) with impaired balance, sensory loss, decreased strength and poor endurance. Outcomes: Over the course of his stay at the hospital the patient demonstrated substantial improvement in his endurance, balance, and functional abilities as compared to his condition upon admission. All goals set by the Student Physical Therapist (SPT) were achieved by discharge on 11/08/15. Discussion: Balance training was more effective than other treatments in all of the articles analyzed. An extensive literature search found six of eight studies examined perturbation exercises compared to other exercise or no exercise. Perturbation balance training was shown to be effective in reducing fall risk and is recommended over other types of exercise in subjects with peripheral neuropathy