Effects of intensive rehabilitation on functioning in patients with mild and moderate Charcot-Marie-Tooth disease: a real-practice retrospective study.
Francesco FerraroDario CalafioreClaudio CurciFrancesco FortunatoIrene CarantiniFilippo GenoveseGiuseppe LucchiniAndrea MerloAntonio AmmendoliaAlessandro de SirePublished in: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2023)
Charcot-Marie-Tooth (CMT) disease is one of the most common inherited neuropathies and can lead to progressive muscular weakness, pes cavus, loss of deep tendon reflexes, distal sensory loss, and gait impairment. There are still no effective drugs or surgical therapies for CMT, and supportive treatment is limited to rehabilitative therapy and surgical treatment of skeletal deformities. Many rehabilitative therapeutic approaches have been proposed, but timing and cadence of rehabilitative intervention are not clearly defined, and long-term follow-up is lacking in literature. The aim of this real-practice retrospective study was to assess the effectiveness of an intensive neurorehabilitation protocol on muscle strength and functioning in CMT patients. We analyzed data of patients with diagnosis of mild to moderate CMT. The rehabilitation program lasted 2-4 h a day, 5 days a week, for 3 weeks and consisted of manual treatments, strengthening exercises, stretching, core stability, balance and resistance training, aerobic exercises, and tailored self-care training. Data were collected at baseline (T 0 ), after treatment (T 1 ), and at the 12-month mark (T 2 ) in terms of the following outcome measures: muscle strength, pain, fatigue, cramps, balance, walking speed, and ability. We included 37 CMT patients with a median age of 50.72 ± 13.31 years, with different forms: demyelinating (n = 28), axonal (n = 8), and mixed (n = 1). After intensive rehabilitation treatment, all outcomes significantly improved. This improvement was lost at the 1-year mark. Taken together, these findings suggest that an intensive rehabilitation program improves short-term symptoms and functional outcomes in a cohort of inpatients affected by mild to moderate CMT.
Keyphrases
- resistance training
- high intensity
- randomized controlled trial
- quality improvement
- body composition
- systematic review
- primary care
- end stage renal disease
- healthcare
- newly diagnosed
- chronic pain
- electronic health record
- chronic kidney disease
- ejection fraction
- spinal cord injury
- type diabetes
- metabolic syndrome
- spinal cord
- bone marrow
- prognostic factors
- machine learning
- combination therapy
- mesenchymal stem cells
- weight loss
- depressive symptoms
- peritoneal dialysis
- artificial intelligence
- patient reported outcomes
- data analysis
- gestational age
- replacement therapy
- deep learning