ROLE OF PHYSIOTHERAPY AND REHABILITATION WITH COOPERATION OF FAMILY IN LOCKED-IN SYNDROME: FOUR-YEAR FOLLOW-UP OF A CASE

Year 2018, Volume: 29 Issue: 3, 95 - 99, 17.12.2018

Bihter Akınoğlu Fatma Aytül Çakçı

https://doi.org/10.21653/tfrd.421951

Cited By: 1

Abstract

Purpose: Locked-in syndrome (LIS) is characterized
by quadriplegia, lower cranial nerve palsy, and mutism. In its classic type,
patients are only able to move their eyes vertically and blink their upper
eyelids. In the classic type of LIS, the patients are depended on a bed, and
all their systems are affected due to immobilization. We presented a four-year
follow-up of a case of LIS undergoing physiotherapy and rehabilitation

Methods: A 51 years old male patient with a classic
type of LIS was applied preventive and supportive physiotherapy and
rehabilitation, and the results of the four-year follow-up were presented. The
physiotherapy and rehabilitation program consisted of the passive range of
motion, positioning, passive cycling, and supported standing up with a device
by the family for seven days a week, and electrotherapy application,
mobilization techniques and bronchial drainage by a physiotherapist at least
three days per week throughout four years.

Results: The patient was free from muscle shortness
or joint limitations over four years. There was not any development of scar or
wound on the skin due to immobilization. The patient was able to manage passive
sitting and standing up position for 15 minutes, and communicate with blinks.

Conclusion: Preventive and supportive physiotherapy
and rehabilitation practice in combination with the family and caregiver
involvement are indispensable for patients in cases requiring care such as LIS.

Keywords

Locked-in syndrome, Physiotherapy, Rehabilitation

ROLE OF PHYSIOTHERAPY AND REHABILITATION WITH COOPERATION OF FAMILY IN LOCKED-IN SYNDROME: FOUR-YEAR FOLLOW-UP OF A CASE

Abstract

Purpose: Locked-in syndrome is characterized by
quadriplegia, lower cranial nerve palsy and mutism. In classic type of it,
patients are only being able to move their eyes vertically and blink upper
eyelid. This syndrome usually occurs due to basilar artery occlusion.  Locked in syndrome secondary to basilar
artery aneurysm is uncommon.

Methods: In this study, we present a four years physical
therapy practice along with home program of a case with locked- in syndrome due
to basilar artery aneurysm treated medically and had coin and stent
application. 

Results: At 4 years follow up, it was found that there was no muscle shortness or
joint limitations. The patient was able to manage passive standing up position
for 15 minutes and communicate with blinks. It was also found that no scar or
wound had been developed on skin.

Conclusion: Herein, it is shown that preventive and
supportive physical therapy and rehabilitation practice combining with home
program, family education and patient attendance is indispensable for patients
with such conditions like locked in syndrome in which care is needed.

Keywords

Locked-in syndrome, Physiotherapy, Rehabilitation

References

• 1. Patterson JR, Grabois M. Locked-In syndome: A review of 139 cases. Stroke 1986;17(4):758-764.2. Ockey RR, Mowry D, Varghese G. Use of sinemet in locked-in syndrome: A report of two cases. Archives of physical medicine and rehabilitation 1995; 76(9):868-870.3. Hocker S, Wijdicks EF. Recovery from Locked-in Syndrome. JAMA neurology, 2015; 72(7):832-833.4. Tvsp M, Gupta P. Locked in Syndrome-A Case Report. Indian Journal of Anaesthesia, 2005;144.5. Smith E, Delargy M. Locked-in syndrome. British Medical Journal 2005;330(7488):406-409.6. Cardwell MS. Locked-in syndrome. Texas medicine 2013; 109(2), e1-e1.7. Casanova E, Lazzari RE, Lotta S, Mazzucchi A. Locked-in syndrome: improvement in the prognosis after an early intensive multidisciplinary rehabilitation. Arch Phys Med Rehabil. 2003;84(6):862-867.