The purpose of this case report is to describe improvements of a novel functional training program in a patient diagnosed with PLS.https://soar.usa.edu/flsaspring2017/1016/thumbnail.jp

Farr, Megan

Perry, Lindsay

English

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Home Evaluations•Environmental barriersFunctional Training Program• Improving safety and independenceAbility to return home SAFELYDon’t Let Me Fall: Implementing the use of assistive standing device with functional task specific training can improve safety of transfers in a 65 y/o woman with Primary Lateral Sclerosis: A Case Report.Megan Farr, SPT and Lindsay Perry PT, DPT, NCSBACKGROUND PURPOSEPrimary Lateral Sclerosis (PLS) is one of the rarest neurodegenerative disorders within the Motor Neuron Disease (MND) spectrum found in 1 to 3% of patients within the MND realm.1Similar to Amyotrophic Lateral Sclerosis (ALS), PLS presents with a dysfunction within the UMN of the corticospinal pathways.2Lack of research to support:3• Specific management of PLS• Physical activity preventing the progression of the disease • Functional improvements due to physical therapy interventionsThe purpose of this case report is to describe improvements  of a novel functional training program in a patient diagnosed with PLS. METHODSRESULTSCASE DESCRIPTIONACKNOWLEDGEMENTSREFERENCESDISCUSSION65 y/o Female 12yr Dx of PLS 6 wks s/p intramedullary nailing of R tibia spiral fractureBody Structure/Function- Hamstring Spasticity- Decreased Endurance- Generalized weaknessActivity Limitations- Non-ambulatory- Dependent transfersParticipation Restrictions- Fear of falling- Limited social outings- Inability to return home safelyPersonal Factors- Power wheelchair- Depression- Anxiety - 12 yr Dx of PLSEnvironmental Factors- Supportive family- Financial support- 4 story home- Narrow elevator* Additionally, she was diagnosed with idiopathic paralysis, hypertension, panicdisorder, hypokalemia, urinary tract infections, and hypomagnesiumCLINICAL RELEVANCEFrank Leahy, Franke at Seaside Skilled Nursing Facility, University of St. Augustine Health SciencesTests and MeasuresPhase 1 Phase 2 Phase 3Numeric Pain Scale Rating(R) LE: 9/10 pain with movement(B) LE: 4/10 pain constantly(R) LE: 4/10 pain with movement(B) LE: 2/10 pain constantly(B) LE: 0/10 painManual Muscle Test(B) LE: 2+/5 with the exception of (R) knee flexion: 1/5 with pain.(B) LE: 3/5 with the exception of (R) knee flexion: 2+/5 with 4/10 pain(B) LE: 3+/5 with the exception of (R) knee flexion: 3/5 RPE RPE: Not tested RPE: 7 RPE: 3Modified Ashworth Scale(B) LE: 0/4 with the exception of (B) hamstrings: 3/4(B) LE: 0/4 with the exception of (B) hamstrings: 3/4(B) LE: 0/4 with the exception of (B) hamstrings: 2/4*Functional Independence MeasureFIM: 63/126= 50% FIM: 76/126= 60% FIM: 111/126= 88%*Quality of Life Scale QoLS: 67/112= 60% QoLS: 74/112= 66% QoLS: 91/112= 81%*Phase One•General Therapeutic Exercise•Static Stretching•HEP•Initial Home EvaluationPhase Two•Transfer Training (Beasyboard/SlideBoard(SB)•HEP•Home EvaluationPhase Three•Transfer training (standing aid)•Sit-to-Stands•HEP•Home EvaluationThe novel functional training program with sit-to-stands demonstrated improvements with functional strength, endurance, and increased independence.Research suggests: • Developing a more functional rehabilitation program is more beneficial than a general strengthening program in patients with ALS.3• Rehabilitation should focus on function-expanding aspects of assistive devises to ensure functional independence and safe mobility at home and in the community.4This supports this case report as benefits from functional and task specific training such as repetitive sit-to-stands had a better effect on the patient’s independence and QoL.Anxiety and depression decreased with utilization of a more functional training protocol during physical therapy.*MCID metPlease SCAN for References

Don’t Let Me Fall: Implementing the Use of Assistive Standing Device with Functional Task Specific Training Can Improve Safety of Transfers in a 65 Y/O Woman with Primary Lateral Sclerosis: A Case Report

https://soar.usa.edu/cgi/viewcontent.cgi?article=1016&amp;context=flsaspring2017

Don’t Let Me Fall: Implementing the Use of Assistive Standing Device with Functional Task Specific Training Can Improve Safety of Transfers in a 65 Y/O Woman with Primary Lateral Sclerosis: A Case Report

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