BalanceWear Improved Balance and Mobility in a Client with Multiple System Atrophy

Posted on December 11, 2015. Filed under: Be Your Best, Hope, Multiple System Atrophy, Physical Therapy, Postural Control, Quality of Life, Video Stories | Tags: , |

Lee Came to the US from the UK looking to try BalanceWear. He had been deteriorating quite a bit the past few months and had great difficulty walking and has balance and mobility issues.

Multiple System Atrophy (MSA) is a rare, incurable disease whose cause is unknown. It currently affects up to .02% of the US population, equally likely to occur in men and women across all ethnic groups. The disease tends to cause initial symptoms in the patient’s 50s, and then rapidly worsens over the course of five to ten years – the patient usually needs the support of an assistive device such as a cane or a walker after only a few years. The earliest symptoms of MSA are similar to the earliest symptoms of Parkinson’s disease; both often begin with slowness of movement, tremor, stiffness, incoordination, and impaired speech. Consequently, it is often difficult to distinguish MSA from Parkinson’s in its early stages. However, unlike Parkinson’s, whose movement-limiting symptoms are caused by the death of nerve cells in a specific, small region of the brain called the substantia nigra, the symptoms of MSA can reflect the death of multiple types of nerve cells in the brain and the spinal cord. Because of the variability in the types of cells that be affected within the MSA diagnosis, a patient’s symptoms generally are classified into one of two types: the parkinsonian type, with characteristics similar to Parkinson’s disease, and the cerebellar type, with characteristics including ataxia and loss of coordination. What both types have in common is a debilitating loss of mobility. Because there is no known cure for the underlying neurodegeneration of MSA, the focus of therapeutic care is on the improvement of the patient’s quality of life by slowing the loss of mobility.

Looks like Lee has new training wheels for the Holidays. We are wishing him the best of luck in his rehabilitation.

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Multiple System Atrophy

Posted on August 27, 2013. Filed under: Balance-Based Torso-Weighting, Multiple System Atrophy, Quality of Life | Tags: , , |

Multiple system atrophy, MSA, is a disease affecting many parts of your body. Much like Parkinson’s disease or cerebellar disease depending on the sub type representing most symptoms.
Symptoms closely related to Parkinson’s are tremor, slow movement, rigidity, and impaired balance and posture. While the cerebellar type is associated with loss of coordination, slurred, slow and or soft voice, difficulty with swallowing, visual disturbances; such a blurred vision or problems focusing. A prominent sign is postural hypotension which involves low blood pressure resulting in dizziness or lightheadedness when changing position from lying or sitting. In some cases there can be a rise in blood pressure when going to a lying position. Patient may also have difficulty controlling their emotions. There are many other symptoms one might experience with MSA.

This blog will discuss treatments with patients on opposite sides of the country.

The first one is today. I recently had the chance to see two individuals with MSA; one in North Carolina and the other in Calaifornia. Both individuals were in their 50’s and had professional careers but were retired due to their illness. Lucky for them they both had wonderful supportive spouses. They were at different stages of MSA.

One gentleman was wheelchair bound, required maximal transfers and could not stand or walk anymore. His wife reported that he was hardly able to read due to blurred and double vision and runs into things with the electric wheelchair. I wasn’t the treating therapist as we had several patients in the treatment room while I was teaching. I did help with his treatment however. He was a rather large individual. In the wheelchair during pretest he was unable to maneuver around cones without running over them. He had emotional outbursts of uncontrollable laughing while driving the electric wheelchair, testing his vision and especially during perturbations (Nudges to see where you fall off balance). His vision was positive for nystagmus (jerkiness of the eyes) and decreased convergence (decreased ability to bring eyes close to center when an object is getting closer to your nose). He held his eyes almost closed like slits. It was maximal effort to transfer him from electric wheelchair to the mat. He could sit with slight posterior loss of balance requiring him to hold his arms closely in front of him. He exhibited uncontrolled laugh.

After testing we placed the weights on him. This actually took the most weight I have ever used, five pounds strategically placed. We got him standing with stand by assist. His wife transferred him with minimal assist. His eyes opened more and were no longer slits. His uncontrolled laughing ceased and he looked relaxed. We repeated the vision tests and they showed some improvement. When we repeated the driving in the electric wheelchair he did not hit the cones. In addition his trunk and arms became relaxed. He watched the next treatment and did not have any outbursts of laughing. Can some of the outburts be associated with uneasiness? Hmm???

His wife stated that giving patients a little more ability is so gratifying to them. To the spouse also. This treatment was going to have the potential to decrease her work in tranfering him from the wheelchair to the chair or other surfaces. This was a double win for this family. Also improving the ability to steer his wheelchair will make everything safer.

I have not worked with many people who have been wheelchair bound but this treatment gives me hope that we can help make a difference for them with BalanceWear!

Stay tuned for the report on the next patient with MSA.

Cindy

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Multiple System Atrophy – Jose shares his story

Posted on October 25, 2012. Filed under: Uncategorized | Tags: , , , , , , , , |

Multiple System Atrophy

Jose has Multiple System Atrophy (MSA), a rare neurological disorder that impairs the autonomic (involuntary) nervous system. Patients with MSA often exhibit ataxia or poor coordination and difficulty walking. MSA shares many symptoms with Parkinson’s Disease, such as rigidity and tremor, but patients experience more widespread damage to their nervous system. Additional symptoms include changes in and/or inability to make facial expressions, dizziness, loss of fine motor skills and balance, loss of the ability to sweat, gait changes, posture difficulties, tremors, voice and vision changes.

Physicians often make a diagnosis based on a patient’s history of symptoms, physical examinations, and ruling out of alternate causes. There is no cure for MSA, and no known way of preventing the progression of the disease in general. The goal of treatment is to manage and control symptoms.

Treatment includes prescription drugs aimed at specific symptoms such as low blood pressure and tremors, and in some cases a pacemaker may be used to regulate a patients heart rate. Physical therapy is an essential part of MSA treatment as well to help patients maintain their mobility and to prevent contractures, falls, and to ensure the patient’s general safety.

When I met Jose he was walking with very small step length…2 inches with a walker. He was going to pain doctors for his neck and back. After testing his balance reactions we placed 1.5 pounds in his BalanceWear orthotic. Immediately his step length increased to 4-5 inch steps. I know that isn’t much but it doubled what he was able to do on the same day. I didn’t see him for a month. When I did his pain in the low back was gone. He is now walking with a cane or without one. He is able to perform many more activities of daily living.

It is not about just changing symptoms. It is about applying interventions that improve mobility, balance and confidence. He still needs therapy to address his neck, improve his stability, endurance and walking.

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