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IMMEDIATE CLINICAL IMPROVEMENT SEEN AFTER BALANCE BODY TORSO WEIGHTING (BBTW) IN A PATIENT WITH SEVERE, CHRONIC CEREBELLAR ATAXIA Andrea Ecsedy PT, NCS, DPT PURPOSE: To assess if the application of Balance Body Torso Weighting (BBTW) on a patient with chronic and severe cerebellar ataxia would result in measurable and objective change. CASE DESCRIPTION: 52 year old man who suffered a brain injury, status post a ranching accident resulting in diffuse axonal damage 7 years ago. FUNCTION: Limited household ambulation with minimal assistance using a front wheeled walker. The patient’s activity level has remained unchanged over the course of the past seven years. Currently, the patient struggles with frequent falls which occur primarily while transferring or ambulating. GOAL: Patient’s goal is to be able to perform safe transfers without losses of balance and to ambulate with minimal supervision and improved confidence.

INTERVENTION: Patient was assessed for BalanceWear vest and weighting utilizing Balance Body Torso Weighting (BBTW) assessment protocol. Patient performed tests listed below, before and after vest application. TABLE: Same session results with and without addition of BBTW

TEST

Pre BBTW

Post BBTW

Difference

MDC threshold

Gait velocity

.60 m/sec

1.36 m/sec

.76 m/sec *

.17 m/sec

TUG

32 sec

28 sec

4 sec *

4 sec

2MWT

70 .4 m

86 m

15.6

16.4 m

Within same session (*) indicates MDC was met CONCLUSION: Application of BBTW resulted in immediate, measurable and objective change in this patient’s balance and gait despite the chronic nature of his condition. Qualitative assessment of the patient’s gait also revealed improved fluidity of movement with improved posture. The patient also reported an increase in his confidence while transferring and moving. CLINICAL MERIT: This patient had demonstrated a functional plateau since his initial course of rehabilitation which was completed 7 years ago. His activity level had significantly declined over the past 5 years secondary to frequent falls as well as an increasing lack of confidence in his ability to change position and ambulate. Improvements in his balance and confidence were demonstrated by increases in gait speed and distance . Consequently allowing this patient to engage in new and more challenging activities. Patient was able to resume physical therapy with the addition of BBTW because of these improvements.

Pre BBTW

Post BBTW

REFERENCES: Widener, GL, Alien DD, Gibson-Horn C. Randomized clinical trial of Balance Body Torso Weighting for improving upright mobility in people with multiple sclerosis. Neurorehabil Neural Repair 2009;23:784-791