GAIT AND STABILITY IMPROVEMENTS IN A PATIENT WITH CERVICAL SPONDYLOTIC MYELOPATHY FOLLOWING FUNCTIONAL NEUROLOGIC INTERVENTIONS

Abstract

Event Abstract Back to Event GAIT AND STABILITY IMPROVEMENTS IN A PATIENT WITH CERVICAL SPONDYLOTIC MYELOPATHY FOLLOWING FUNCTIONAL NEUROLOGIC INTERVENTIONS Jacob Plasker1* and Susan Esposito1 1 Life University, United States Background: A 35 year-old female presented with marked gait disturbances following a fall. Cervical MRI revealed evidence of cord compression from C5-C7 with increased signal indicating degenerative changes. Foot-drop was evident along with severe spasticity of the entire right lower extremity making unassisted ambulation difficult. She reported right hand weakness and that she frequently dropped small items. Gait analysis revealed decreased right arm swing that improved with dual tasking. Other findings included a right grade three finger-tapping test, a functional impairment in rapid alternating movements of the right upper extremity, and complete inability to perform heel-to-shin test on the right due to spasticity. Point localization accuracy was noticeably impaired in both right extremities. Ocular abnormalities included bilateral hypometric saccades, decreased gain of pursuits bilaterally, and inability to hold constriction on light reflex testing bilaterally. Lower extremity myotatic reflexes were 3+ bilaterally and were associated with a midline trunkal titubation. Methods: Patient’s treatment protocol consisted of variable resistance exercises of the right lower extremity and left brain eye exercises. Gait therapy consisting of serial subtraction by threes while listening to rhythmic music through headphones in the right ear. Point localization therapy was also utilized on both the upper and lower extremity. She was treated once a week for three months. Results: The patient was able to ambulate unassisted and more confidently. Spasticity in her right lower extremity was markedly reduced. Her finger tapping grade was reduced to 1. Pupillary light reflex held for two seconds bilaterally. Point localization errors decreased from approximately 4 to 1.5 inches, and the patient was able to perform heel to shin testing. Myotatic reflexes remained unchanged at 3+, but the amplitude of the simultaneous titubation was markedly decreased. Conclusions: In this case we saw marked improvements in functional gait outcomes that were achieved even in the presence of gross anatomical degeneration. More research into the mechanism underlying these processes is warranted. Acknowledgements Special thanks to the instructors at the Carrick institute and Life University for their guidance and commitment to first class education and training. Keywords: Functional Neurology, Cervical myelopathy, Gait Disorders, Neurologic, Neurorehabilitation, Clinical Neuroscience Conference: International Symposium on Clinical Neuroscience: TBI and Neurodegeneration, Orlando, Florida, United States, 10 Dec - 14 Dec, 2015. Presentation Type: Poster Presentation Topic: Case Reports for Poster Presentation Citation: Plasker J and Esposito S (2015). GAIT AND STABILITY IMPROVEMENTS IN A PATIENT WITH CERVICAL SPONDYLOTIC MYELOPATHY FOLLOWING FUNCTIONAL NEUROLOGIC INTERVENTIONS. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience: TBI and Neurodegeneration. doi: 10.3389/conf.fneur.2015.58.00038 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 31 Oct 2015; Published Online: 02 Nov 2015. * Correspondence: Mr. Jacob Plasker, Life University, marietta, ga, 30060, United States, jplasker@student.life.edu Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Jacob Plasker Susan Esposito Google Jacob Plasker Susan Esposito Google Scholar Jacob Plasker Susan Esposito PubMed Jacob Plasker Susan Esposito Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.