The course of physical therapy in patient with spasticity paraparesis with intrathecal baclofen therapy : a case report

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  • ITB療法(Intrathecal Baclofen Therapy)により歩行能力が向上した進行性の痙性対麻痺患者の理学療法の経験
  • ITB リョウホウ Intrathecal Baclofen Therapy ニ ヨリ ホコウ ノウリョク ガ コウジョウ シタ シンコウセイ ノ ケイセイ ツイ マヒ カンジャ ノ リガク リョウホウ ノ ケイケン

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Abstract

Intrathecal baclofen (ITB) therapy is an effective treatment for the patient with severe spasticity due to the spinal disorders. There are many reports on ITB, but few reports on physical therapy with ITB. A 59 years-old man with chronic progressive spastic paraparesis, had had the difficulty to stand and walk since 15 years. He was given ITB therapy, followed by physical therapy for 10 weeks. Gait time was improved for postoperative 2-3 weeks with the spasticity reduction with ITB administration starting; however, it was temporally deteriorated from postoperative 4 to 8 weeks for 5 weeks. Finally his spasticity was improved, resulting into gaining the standing and walking ability outside. His walking distance, Manual Muscle Test, and motor Functional Independence Measure were also improved over 10 weeks of ITB therapy. As a result of having continuous physical therapy and medical management, he has gotten the ability to walk and work outside. A significant improvement in the patient's symptoms with ITB was found, and physical therapy was effective to improve the coordination of low extremities, the increasing muscle output, and the relearning of his gait pattern. It is important for patients with severe spasticity with ITB administration to receive physical therapy that is suitable to their condition.

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