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Sunday, August 21, 2011

[AlternativeAnswers] Treatment for a 14-Year-Old Girl With Lyme Disease Using Therapeutic Exercise a


Treatment for a 14-Year-Old Girl With Lyme Disease Using Therapeutic
Exercise and Gait Training.

Moser MM

Phys Ther 2011 07 7

BACKGROUND AND PURPOSE:/b> Lyme disease is well documented in the
literature; however, specific physical therapy interventions for the
pediatric population with residual effects of Lyme disease have not been
addressed. The purposes of this retrospective case report are:
(1) to present an example therapeutic intervention for a pediatric
patient in the late stages of Lyme disease with related musculoskeletal
dysfunction and severely impaired quality of life,
(2) to report the patient's functional outcomes from treatment, and
(3) to discuss implications for treatment of patients with
musculoskeletal dysfunction in the late stages of Lyme disease.
CASE DESCRIPTION: /b> The patient was a 14-year old girl who had
contracted Lyme disease 1 year prior to initiation of physical therapy.
She was unable to participate with her peers in school, church, and
sporting events due to significant impairments in strength
(force-generating capacity), endurance, and gait; fatigue; pain; a nd
total body tremor. Therapeutic exercise and gait training were used for
treatment. The patient actively participated in managing her care by
providing feedback during interventions and setting goals.
OUTCOMES: /b> After 18 weeks of treatment, the patient achieved 96.7%
of her predicted distance on the Six-Minute Walk Test with normal gait
mechanics and returned to playing high school sports. She had a manual
muscle test grade of 4/5 or greater in major extremity muscle groups.
She returned to school and church participation with minimal total body
tremor when fatigued and daily pain rated 0 to 3/10.
DISCUSSION:/b> Therapeutic exercise and gait training may facilitate
return to function in an adolescent patient with late effects of Lyme
disease. Further investigation is advised to establish treatment effects
in a broader population.

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