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

Abstract

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.