Amy J. Litterini
© 2019 Hanna Geib
Background and Purpose: Peripheral polyneuropathy (PPN) is a condition resulting from damage to the peripheral nervous system, causing sensory abnormalities (e.g. tingling, burning, and loss of sensation) occurring distally to proximally. Individuals with PPN experience proprioceptive sensory loss and muscle weakness, resulting in decreased functional mobility. A common cause of PPN is diabetes mellitus, however 20-25% of cases are deemed idiopathic. Interventions of balance training and lower extremity strengthening have been shown to have a small positive effect on the progression of PPN. The purpose of this case report is to describe the physical therapy (PT) management of an elderly patient with PPN, elevated fall-risk, and deconditioning. Case Description: An 81-year-old male who presented with complaints of decreased bilateral foot sensation, unsteadiness in gait, and lower extremity (LE) weakness secondary to a diagnosis of LE PPN received PT twice per week for nine weeks. The PT plan of care included LE strengthening, balance training, and aerobic conditioning. Outcomes included the Lower Extremity Functional Scale (LEFS), Activities-Specific Balance Confidence (ABC) Scale, Timed Up & Go (TUG), and Five Times Sit to Stand (5xSTS). Outcomes: The LEFS improved from 15/80 to 33/80 and the ABC scale improved from 27.5% to 47.5%. The TUG and 5xSTS times improved from 14.75 seconds to 11.81 seconds and from 27.6 seconds to 18.85 seconds, respectively. Discussion: Interventions of standing balance training and LE strengthening exercises are safe and may have contributed to improving the patient’s functional mobility despite his progressive PPN. Future research would benefit current literature by investigating the effectiveness of standing balance exercises with internal and external perturbations in combination with LE strengthening exercises in patients with PPN.
Geib, Hanna, "Balance And Strength Interventions For An Older Individual With Peripheral Polyneuropathy: A Case Report" (2019). Case Report Papers. 102.