Physical therapy intervention with a low frequency of exercise for a patient with a complicated form of hereditary spastic paraplegia: a case report.
Mamoru Sato, Kazuya Kannari, Makiko Tomari and 1 others
PMID 31417219WHAT IT FOUND
In a man with complicated hereditary spastic paraplegia, 24 low-frequency physical therapy sessions over 3 months were followed by reported maintenance of muscle strength, bathing ability, and standing/gait posture.
This describes what happened to a single person, not proof the programme works.
Key findings
01After 24 sessions over 3 months, grip force and quadriceps strength were reported as maintained.
02At 3 months, no Barthel item scores changed, and the patient still bathed once a week without accidents.
03Standing and gait posture showed no remarkable change after the 24-session programme.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a case report of a single patient, so it cannot show that the programme caused the reported maintenance. There was no control group, comparison programme, randomisation, or blinding, and the natural course of hereditary spastic paraplegia was not measured. The patient had complicated hereditary spastic paraplegia with blindness and verbal IQ 71, so the findings may not apply to other people with hereditary spastic paraplegia. The programme included several exercises, verbal instruction, and personal practice, so the contribution of any single component cannot be separated. Follow-up was only 3 months, so longer-term functional change is not addressed.
Declared interests
No conflicts of interest were declared.
The easy way to misread this
Do not conclude that this low-frequency programme prevents functional decline in hereditary spastic paraplegia. This was a single patient with no control group, and the 3-month follow-up cannot separate the effects of squatting, sideways kneeling weight bearing, hip abduction control, Q-cane gait, bath motion exercise, verbal instruction, and personal practice.