The Short and Intensive Rehabilitation (SHAiR) Program Improves Dropped Head Syndrome Caused by Amyotrophic Lateral Sclerosis: A Case Report

Abstract

Background and Objectives: Dropped head syndrome (DHS) is a syndrome that presents with correctable cervical kyphotic deformity as a result of weakening cervical paraspinal muscles. DHS with amyotrophic lateral sclerosis (ALS) is a relatively rare condition, and there is no established treatment. This is the first case report describing the improvement of both dropped head (DH) and cervical pain after the short and intensive rehabilitation (SHAiR) program in an ALS patient with DHS. Case Report: After being diagnosed with ALS in June 2020, a 75-year-old man visited our hospital in October 2020 to receive treatment for DHS. At the initial visit, the patient’s DH was prominent during standing and walking. The pain intensity of the neck was 9 out of 10 on the numerical rating scale (NRS), which was indicative of severe pain. The patient was hospitalized for 2 weeks and admitted into the SHAiR program. DH began to decrease one week after undergoing the SHAiR program and improved two weeks later. Neck pain decreased from 9 to 6 on the NRS. Results: The SHAiR program is a rehabilitation program aimed at improving DH in patients with idiopathic DHS. The program was designed to improve neck extensor and flexor function and global spinal alignment, and the program may have contributed to the improvement of DH and neck pain. Currently, reports of conservative therapies for this disease are limited to the use of cervical orthosis. Although further research is needed on the safety and indications of treatment, the SHAiR program may be a viable treatment option.

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“…Neurofeedback after Stem cell transplantation 30 d Temporary improvement Sharma et al [22] Male 40 Muscle atrophy of the limbs and weakness of the neck muscles Cell therapy and neurorehabilitation 16 mo Temporary improvement Hassan et al [23] Male 52 Unable to grip and falls frequently Stem cell therapy Twice (2 d) Loss of motor function after 6 mo Urata et al [24] Male 75 Dropped head syndrome Short-term intensive exercise program 2 wk Temporary improvement Lu gaochen et al [25] Female 48 Weakness of the limbs Washed microbiota transplantation 1 yr Maintain the status quo ALS = amyotrophic lateral sclerosis. www.md-journal.com results from the third test show improvements when compared to those from the first test, it is very difficult to predicate how long the effects of this treatment will be maintained.…”