© 2015 Paige Blasco
Background and Purpose: Charcot-Marie-Tooth disease (CMT) is a neuromuscular disease that leads to distal muscle atrophy, weakness, and sensory loss. Myocardial infarction (MI) is often a result of coronary artery disease, which has an incidence rate of 34.6% in men over 80. While rehabilitation practices for CMT and MI have been described separately, there is a paucity of research investigating physical therapy (PT) interventions for patients who have both health conditions. The purpose of this case report was to investigate the PT management of a patient with CMT following an acute MI in the acute and sub-acute care settings. Case Description: The patient was an 80-year-old male with CMT who was admitted to the hospital with an MI. His hospital course was further complicated by respiratory failure, which necessitated prolonged bed rest. After 6 days in the ICU, he received 30 minutes/day of acute care PT for four days, followed by two daily one-hour sessions of inpatient rehab PT for five days. Interventions included progressive balance, functional mobility, and advanced gait training. Outcomes: The Physical Function in ICU Test (PFIT) score improved from 8/12 to 12/12 during his acute care stay. In inpatient rehab, his Functional Independence Measure (FIM) scores for mobility and all transfers improved by at least one point, his Two-Minute Walk Test (2MWT) distance improved from 80.8 to 99.1 meters, and he was successfully discharged home. Discussion: CMT and MI in combination can be especially debilitating. An aggressive rehabilitation course that promoted balance, functional mobility and progressive gait training appeared to substantially benefit an 80-year-old patient’s physical function and contribute to his potential for independent living in the community.
Blasco, Paige, "A Progressive Physical Therapy Plan Of Care For A Patient With Charcot-Marie-Tooth Disease Following Myocardial Infarction: A Case Report" (2015). Case Report Papers. 42.