Impact of structured physical therapy intervention on functional recovery in a patient with CAPOS syndrome: a case report

Abstract

Background CAPOS syndrome (cerebellar ataxia, areflexia, pescavus, optic atrophy, and sensorineural hearing loss) is a rare congenital autosomal dominant disorder. The resulting neurological sequelae of impairments are progressive in nature and may interfere with functional independence, performing activities of daily living (ADL’s), and subsequently, affecting the quality of life (QOL). Since it is an extremely rare disorder, there is a severe dearth in the literature about how specific physiotherapy interventions may affect their functional status. Therefore, our objective was to investigate the effects of proprioceptive neuromuscular facilitation (PNF) and Frenkel’s coordination exercises on functional recovery in a patient with CAPOS syndrome. Case presentation We herein present a case of a 25-year-old Indian male with complaints of generalized body weakness, difficulty visualizing distant objects, nystagmus, progressive sensorineural deafness, and ataxia. He was rehabilitated with a structured/customized physiotherapy protocol consisting of PNF approach and coordination exercises for 4 weeks, 6 days/week, 60 min daily. An improvement in overall functional performance of patient as per post-intervention scores of manual muscle testing, trunk control measurement scale, functional independence measure (components of self-care, transfers, and locomotion), and decline in severity of ataxia on scale for assessment and rating of ataxia scale was observed. Conclusion PNF and Frenkel’s exercises resulted in an improvement in overall functional performance of the patient. Improvement was observed in post-test scores of Manual Muscle Testing (MMT), Trunk Control Measurement Scale (TCMS), and Functional Independence Measure (FIM) for the components of self-care, transfers, and locomotion. Additionally, results also showed a decline in severity of ataxia on post-test scores of scale for the assessment and rating of ataxia (SARA) scale (i.e., from severe to moderate).

Efficacy of the Structured Physiotherapeutic Program in Patients with Cerebellar Ataxia: Impact on Severity, Balance, and Motor Recovery in Indian Population

“…In structured physiotherapeutic program, Frenkel's exercises, namely perception, precision, practice, peak performance and progression and diagonal PNF patterns were incorporated during the intervention to achieve functional movement synergies. [7] The home based exercise regimen was focused on balancing exercises such as side to side weight transfer, foot circles, forward reach, toe touches. Further, the findings of the present study revealed that both structured physiotherapeutic program as well as home based exercise regimen, are equally effective in diminishing the affection of ataxia in these patients.…”

“…The final score was the time in seconds of the quicker of two timed trials. [7] : The patients were administered six therapy sessions per week for a total duration of 4 weeks with each therapy session lasting for 60 minutes, with appropriate rest intervals. The detailed description of exercise intervention in this program has been included in Table 1.…”