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

Özet

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.

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.