Rehabilitation in Devica’s Syndrome. Case Report

Abstract

Introduction: Devic’s syndrome also known as neuromyelitis optica is an autoimmune disease of central nervous system (CNS).It has an inflammatory, demyelizatory, chronic and relapsing nature, where ones own immune system attacks the spinal cord and optic nerves. Material and Methods: The authors presented a case report of a 54-year-old woman diagnosed with Devic’s syndrome 2 years ago. The physiotherapeutic examination revealed: visual and balance disturbances, decrease in muscle strength of upper and lower limbs, unsteady and shaky gait with a need to use a zimmer frame. At the start and at the end of a therapy, to objectively monitor the progress of rehabilitation treatment, a number of functional tests were used that included: Barthel Index, Brunnstrom’s test, Rankin Scale, Ashworth’s scale, Lovett’s test and a timed 20m walk. In physiotherapeutic treatment process patterns and techniques of PNF (prioprioceptive neuromuscular facilitation) ware used as well as exercise to correct muscles tone and strengthening exercise of trunk and lower limbs. Results: As a result of applying a comprehensive rehabilitation approach an increase of muscles strength of upper and lower limbs was obtained (Lovett’s scale R/L: shoulder 5/5, elbow 5/5, hand 5/5, hip 4+/4+, knee 4+/4+, foot 4+/4+). In addition all postural muscles gained in strength and an improvement in hands dexterity, body coordination and balance was noticed. Conclusion: Multidisciplinary approach and an individually selected rehabilitation program proves to show beneficial effects in a treatment process of patients with Devic’s syndrome.