Case Report
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NIEMANN PİCK HASTALIĞI TİP B'DE TELEREHABİLİTASYONUN ETKİSİ: BİR OLGU SUNUMU

Year 2026, Volume: 4 Issue: 1, 30 - 36, 23.01.2026

Abstract

Amaç: Bu çalışmanın amacı, Niemann Pick Hastalığı Tip B (NPD-B) hastasında 12 haftalık telerehabilitasyon programının kas kuvveti, hareket açıklığı, motor performans ve solunum fonksiyonu üzerindeki etkilerini araştırmaktı.
Yöntem: NPD-B tanısı konulan 13 yaşındaki bir erkek çocuk çalışmaya katıldı ve 12 hafta boyunca haftada üç seans, her seans 60 dakika süreyle telerehabilitasyon programı uygulandı. 6 dakikalık yürüme testi (6-MWT) ve süreli performans testleri motor fonksiyonu belirlemek için kullanıldı. Hastanın hareket açıklığı (ROM) gonyometre kullanılarak ölçüldü. Kas kısalığı, mezura ve gonyometre kullanılarak değerlendirildi. Kas gücü, miyometrik ölçümle değerlendirildi. Spirometri testi, pulmoner fonksiyonu ölçmek için kullanıldı. Değerlendirmeler, telerehabilitasyon programı öncesinde ve sonrasında uygulandı.
Sonuçlar: 6-MWT'de 61 metrelik bir artış gözlendi. Hastanın sağ ve sol kalça fleksör kas kısalığı sırasıyla 7,0 ve 9,0 derece düzeldi. Gastroknemius kas kısalığında da iyileşmeler gözlendi (sağ 12, sol 7 derece). Diz ekstansiyonu ve sol ayak bileği normal ROM'a ulaştı. Hastanın sağ omuz, sol omuz, sağ kalça ve sol kalça fleksiyon kas gücü sırasıyla 6,0, 6,0, 8,4 ve 11,6 pound arttı. Hastanın bir saniyedeki zorlu ekspiratuar hacim/zorlu vital kapasite oranı (FEV1/FVC) değeri telerehabilitasyon öncesinde %87, telerehabilitasyon sonrasında ise %89 idi. Telerehabilitasyon programı sırasında herhangi bir yan etki gözlenmedi.
Sonuç: Bu bulgular, 12 haftalık telerehabilitasyon programının tıbbi tedavilere ek olarak Niemann-Pick Hastalığı Tip B (NPD-B) yönetimine katkıda bulunan bir tedavi yöntemi olarak kullanılabileceğini göstermektedir. Ancak, bu hastalıkta daha fazla sayıda katılımcıyla kontrollü çalışmalara ihtiyaç duyulmaktadır.

References

  • 1. Schuchman EH, Desnick RJ. Types a and B Niemann-pick disease. Molecular genetics and metabolism. 2017;120(1-2):27-33.
  • 2. Schuchman EH, Wasserstein MP. Types A and B niemann-pick disease. Best practice & research Clinical endocrinology & metabolism. 2015;29(2):237-47.
  • 3. McGovern MM, Wasserstein MP, Giugliani R, Bembi B, Vanier MT, Mengel E, et al. A prospective, cross-sectional survey study of the natural history of Niemann-Pick disease type B. Pediatrics. 2008;122(2):e341-e9.
  • 4. Simpson Jr WL, Mendelson D, Wasserstein MP, McGovern MM. Imaging manifestations of Niemann-Pick disease type B. American Journal of Roentgenology. 2010;194(1):W12-W9.
  • 5. von Ranke FM, Pereira Freitas HM, Mançano AD, Rodrigues RS, Hochhegger B, Escuissato D, et al. Pulmonary involvement in Niemann–Pick disease: a state-of-the-art review. Lung. 2016;194:511-8.
  • 6. Guillemot N, Troadec C, de Villemeur TB, Clément A, Fauroux B. Lung disease in Niemann–Pick disease. Pediatric pulmonology. 2007;42(12):1207-14.
  • 7. Mendelson DS, Wasserstein MP, Desnick RJ, Glass R, Simpson W, Skloot G, et al. Type B Niemann-Pick disease: findings at chest radiography, thin-section CT, and pulmonary function testing. Radiology. 2006;238(1):339-45.
  • 8. Matencio A, Navarro-Orcajada S, González-Ramón A, García-Carmona F, López-Nicolás JM. Recent advances in the treatment of Niemann pick disease type C: A mini-review. International Journal of Pharmaceutics. 2020;584:119440.
  • 9. Wraith JE, Baumgartner MR, Bembi B, Covanis A, Levade T, Mengel E, et al. Recommendations on the diagnosis and management of Niemann-Pick disease type C. Molecular genetics and metabolism. 2009;98(1-2):152-65.
  • 10. Keskin DB. Rehabilitation is an Important Pillar of the Treatment in Patients with Niemann Pick Disease Type C: A Case Report. Turkish Journal of Pediatric Disease.13(2):116-9.
  • 11. Joschtel B, Gomersall SR, Tweedy S, Petsky H, Chang AB, Trost SG. Effects of exercise training on physical and psychosocial health in children with chronic respiratory disease: a systematic review and meta-analysis. BMJ open sport & exercise medicine. 2018;4(1):e000409.
  • 12. Harding AT, Beck BR. Exercise, osteoporosis, and bone geometry. Sports. 2017;5(2):29.
  • 13. McDonald CM, Henricson EK, Abresch RT, Florence J, Eagle M, Gappmaier E, et al. The 6‐minute walk test and other clinical endpoints in duchenne muscular dystrophy: reliability, concurrent validity, and minimal clinically important differences from a multicenter study. Muscle & nerve. 2013;48(3):357-68.
  • 14. Goemans N, Van den Hauwe M, Wilson R, Van Impe A, Klingels K, Buyse G. Ambulatory capacity and disease progression as measured by the 6-minute-walk-distance in Duchenne muscular dystrophy subjects on daily corticosteroids. Neuromuscular Disorders. 2013;23(8):618-23.
  • 15. Pandya S, Florence JM, King WM, Robison JD, Oxman M, Province MA. Reliability of goniometric measurements in patients with Duchenne muscular dystrophy. Physical Therapy. 1985;65(9):1339-42.
  • 16. Otman AS, Demirel H, Sade A. Tedavi hareketlerinde temel değerlendirme prensipleri: Pelikan yayıncılık; 2014.
  • 17. Sloan C. Review of the reliability and validity of myometry with children. Physical & occupational therapy in pediatrics. 2002;22(2):79-93.
  • 18. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. European respiratory journal. 2005;26(2):319-38.
  • 19. Liou TG, Kanner RE. Spirometry. Clinical reviews in allergy & immunology. 2009;37:137-52.
  • 20. Borg GA. Psychophysical bases of perceived exertion. Medicine and science in sports and exercise. 1982;14(5):377-81.
  • 21. Smart NA, Downes D, Van Der Touw T, Hada S, Dieberg G, Pearson MJ, et al. The effect of exercise training on blood lipids: a systematic review and meta-analysis. Sports Medicine. 2024:1-12.
  • 22. Yu MKL, Chiu AYY, Chau SK, Rosa Duque JS, Wong WHS, Chan SHS. A pilot study of an integrated, personalized, respiratory and motor telerehabilitation program for pediatric patients with hereditary neuromuscular disorders. Muscle & Nerve. 2023;68(6):857-64.
  • 23. Brody LT. Effective therapeutic exercise prescription: the right exercise at the right dose. Journal of Hand Therapy. 2012;25(2):220-32.
  • 24. Behm DG, Alizadeh S, Daneshjoo A, Anvar SH, Graham A, Zahiri A, et al. Acute effects of various stretching techniques on range of motion: A systematic review with meta-analysis. Sports medicine-open. 2023;9(1):107.
  • 25. Chuter V, De Jonge XJ, Thompson B, Callister R. The efficacy of a supervised and a home-based core strengthening programme in adults with poor core stability: a three-arm randomised controlled trial. British journal of sports medicine. 2015;49(6):395-9.

Effects of Telerehabilitation in Niemann Pick Disease Type B: A Case Report

Year 2026, Volume: 4 Issue: 1, 30 - 36, 23.01.2026

Abstract

Purpose: The aim of this study was to investigate the effects of a 12-week telerehabilitation on muscle strength, range of motion, motor performance and pulmonary function in a patient with Niemann Pick Disease Type B (NPD-B).
Method: A 13-year-old boy diagnosed with NPD-B participated in the study and underwent a telerehabilitation program for 12 weeks, three sessions per week, each session lasting 60 minutes. The 6-minute walk test (6-MWT) and timed performance tests were used to determine motor function. The patient's range of motion (ROM) was measured using a goniometer. Muscle shortness was evaluated using a tape measure or a goniometer. Muscle strength was assessed using myometric measurement. Spirometry test was used to measure pulmonary function. Assessments were applied before and after the telerehabilitation program.
Results: A 61-meter increase was observed in the 6-MWT. The patient's right and left hip flexor muscle shortness improved by 7.0 and 9.0 degrees, respectively. Improvements were also observed in gastrocnemius muscle shortness (right 12, left 7 degrees). Knee extension and left ankle dorsiflexion reached normal ROM. The right shoulder, left shoulder, right hip, and left hip flexion muscle strength of the patient increased by 6.0, 6.0, 8.4, and 11.6 pounds, respectively. The patient’s forced expiratory volume in one second/forced vital capacity ratio (FEV1/FVC) value was 87% before the telerehabilitation program and 89% after the telerehabilitation program. No side effects were reported during the telerehabilitation program.
Discussion: These findings suggest that 12-week telerehabilitation program can be used as a treatment method that contributes to the management of Niemann-Pick Disease Type B (NPD-B) in addition to medical treatments. However, controlled studies with a larger number of participants in this disease are needed.

References

  • 1. Schuchman EH, Desnick RJ. Types a and B Niemann-pick disease. Molecular genetics and metabolism. 2017;120(1-2):27-33.
  • 2. Schuchman EH, Wasserstein MP. Types A and B niemann-pick disease. Best practice & research Clinical endocrinology & metabolism. 2015;29(2):237-47.
  • 3. McGovern MM, Wasserstein MP, Giugliani R, Bembi B, Vanier MT, Mengel E, et al. A prospective, cross-sectional survey study of the natural history of Niemann-Pick disease type B. Pediatrics. 2008;122(2):e341-e9.
  • 4. Simpson Jr WL, Mendelson D, Wasserstein MP, McGovern MM. Imaging manifestations of Niemann-Pick disease type B. American Journal of Roentgenology. 2010;194(1):W12-W9.
  • 5. von Ranke FM, Pereira Freitas HM, Mançano AD, Rodrigues RS, Hochhegger B, Escuissato D, et al. Pulmonary involvement in Niemann–Pick disease: a state-of-the-art review. Lung. 2016;194:511-8.
  • 6. Guillemot N, Troadec C, de Villemeur TB, Clément A, Fauroux B. Lung disease in Niemann–Pick disease. Pediatric pulmonology. 2007;42(12):1207-14.
  • 7. Mendelson DS, Wasserstein MP, Desnick RJ, Glass R, Simpson W, Skloot G, et al. Type B Niemann-Pick disease: findings at chest radiography, thin-section CT, and pulmonary function testing. Radiology. 2006;238(1):339-45.
  • 8. Matencio A, Navarro-Orcajada S, González-Ramón A, García-Carmona F, López-Nicolás JM. Recent advances in the treatment of Niemann pick disease type C: A mini-review. International Journal of Pharmaceutics. 2020;584:119440.
  • 9. Wraith JE, Baumgartner MR, Bembi B, Covanis A, Levade T, Mengel E, et al. Recommendations on the diagnosis and management of Niemann-Pick disease type C. Molecular genetics and metabolism. 2009;98(1-2):152-65.
  • 10. Keskin DB. Rehabilitation is an Important Pillar of the Treatment in Patients with Niemann Pick Disease Type C: A Case Report. Turkish Journal of Pediatric Disease.13(2):116-9.
  • 11. Joschtel B, Gomersall SR, Tweedy S, Petsky H, Chang AB, Trost SG. Effects of exercise training on physical and psychosocial health in children with chronic respiratory disease: a systematic review and meta-analysis. BMJ open sport & exercise medicine. 2018;4(1):e000409.
  • 12. Harding AT, Beck BR. Exercise, osteoporosis, and bone geometry. Sports. 2017;5(2):29.
  • 13. McDonald CM, Henricson EK, Abresch RT, Florence J, Eagle M, Gappmaier E, et al. The 6‐minute walk test and other clinical endpoints in duchenne muscular dystrophy: reliability, concurrent validity, and minimal clinically important differences from a multicenter study. Muscle & nerve. 2013;48(3):357-68.
  • 14. Goemans N, Van den Hauwe M, Wilson R, Van Impe A, Klingels K, Buyse G. Ambulatory capacity and disease progression as measured by the 6-minute-walk-distance in Duchenne muscular dystrophy subjects on daily corticosteroids. Neuromuscular Disorders. 2013;23(8):618-23.
  • 15. Pandya S, Florence JM, King WM, Robison JD, Oxman M, Province MA. Reliability of goniometric measurements in patients with Duchenne muscular dystrophy. Physical Therapy. 1985;65(9):1339-42.
  • 16. Otman AS, Demirel H, Sade A. Tedavi hareketlerinde temel değerlendirme prensipleri: Pelikan yayıncılık; 2014.
  • 17. Sloan C. Review of the reliability and validity of myometry with children. Physical & occupational therapy in pediatrics. 2002;22(2):79-93.
  • 18. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. European respiratory journal. 2005;26(2):319-38.
  • 19. Liou TG, Kanner RE. Spirometry. Clinical reviews in allergy & immunology. 2009;37:137-52.
  • 20. Borg GA. Psychophysical bases of perceived exertion. Medicine and science in sports and exercise. 1982;14(5):377-81.
  • 21. Smart NA, Downes D, Van Der Touw T, Hada S, Dieberg G, Pearson MJ, et al. The effect of exercise training on blood lipids: a systematic review and meta-analysis. Sports Medicine. 2024:1-12.
  • 22. Yu MKL, Chiu AYY, Chau SK, Rosa Duque JS, Wong WHS, Chan SHS. A pilot study of an integrated, personalized, respiratory and motor telerehabilitation program for pediatric patients with hereditary neuromuscular disorders. Muscle & Nerve. 2023;68(6):857-64.
  • 23. Brody LT. Effective therapeutic exercise prescription: the right exercise at the right dose. Journal of Hand Therapy. 2012;25(2):220-32.
  • 24. Behm DG, Alizadeh S, Daneshjoo A, Anvar SH, Graham A, Zahiri A, et al. Acute effects of various stretching techniques on range of motion: A systematic review with meta-analysis. Sports medicine-open. 2023;9(1):107.
  • 25. Chuter V, De Jonge XJ, Thompson B, Callister R. The efficacy of a supervised and a home-based core strengthening programme in adults with poor core stability: a three-arm randomised controlled trial. British journal of sports medicine. 2015;49(6):395-9.
There are 25 citations in total.

Details

Primary Language English
Subjects Physiotherapy
Journal Section Case Report
Authors

Aslı Bayram 0009-0001-3217-107X

Hacer Sultan Öztürk 0009-0005-1513-7055

Ali Naim Ceren 0000-0002-1617-6946

İpek Gürbüz 0000-0001-5556-6608

Öznur Tunca Yılmaz 0000-0002-0855-9541

Numan Bulut 0000-0001-5427-1103

Submission Date March 29, 2025
Acceptance Date October 9, 2025
Publication Date January 23, 2026
Published in Issue Year 2026 Volume: 4 Issue: 1

Cite

Vancouver 1.Bayram A, Öztürk HS, Ceren AN, Gürbüz İ, Tunca Yılmaz Ö, Bulut N. Effects of Telerehabilitation in Niemann Pick Disease Type B: A Case Report. JHUPTR [Internet]. 2026 Jan. 1;4(1):30-6. Available from: https://izlik.org/JA65EZ85WL