chronic inflammatory demyelinating polyneuropathy
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Chronic Inflammatory Demyelinating Polyneuropathy. By : Kyle Leato, SPTA. OBJECTIVES. Provide background information Clinical Presentation Cause Treatment Importance to Physical Therapy Conclusion. Background Information. What is CIDP?

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Presentation Transcript
  • Provide background information
  • Clinical Presentation
  • Cause
  • Treatment
  • Importance to Physical Therapy
  • Conclusion
background information
Background Information
  • What is CIDP?
    • It is a common, under diagnosed immune-mediated inflammatory disorder of the peripheral nervous system. (Hartung, et al., 2005)
  • Commonly referred to as:
    • chronic relapsing polyneuropathy
  • Closely related to:
    • Guillain-Barré syndrome.
  • Prevalence:
    • 0.5 out of 100,000 children
    • 1-2 per 100,000 adults
  • The body’s immune system attacks the nerves in the periphery, affecting the limbs and organs of the body

(Forsberg, Press & Westblad, 2009)

  • Occurrence of symmetrical weakness in both proximal and distal muscles that progressively increases for more than 2 months.
  • Impaired sensation, burning and weakness ( generally occurring in the feet first and they gradually ascend to involve other parts of the body). 
  • Absent or diminished tendon reflexes.
  • Elevated CSF protein level.
  • Signs of demyelination (in nerve biopsy specimens).
  • Foot drop.
  • When organs become involved: inability to adequately empty the bladder, nausea, vomiting, abdominal fullness or bloating, diarrhea, or constipation, low blood with dizziness, or trouble maintaining an erection. 

****The severity and the combination of symptoms vary for each patient.

  • Early Stages:
    • Typically PROM and positioning is used.
    • Family Education
  • Middle Stages:
    • Tactile re-training (brushing, vibration and tapping)
    • Light resistive exercises
    • PNF if the patient is capable
  • Late Stages:
    • Transfer Training
    • Gait Training with the use of an AD
    • Progressive Resistive Exercises
other treatment ideas
Other Treatment Ideas
  • Land Based Exercising:
    • Alter G Treadmill for reduced body weight walking. Increased weight bearing over a period of time is shown to increase strength and the ability to ambulate independently. (Greenwood & Tuckey, 2004)
  • Water Based Exercise:
    • Hydro Physio Underwater Treadmill can be altered by increasing or decreasing the amount of water in the tank.
    • Aquatic therapy has shown to be very beneficial to one of our own patients.
youtube video
Youtube Video

importance in relation to physical therapy
Importance in Relation to Physical Therapy
  • What can we as a physical therapy team do?
    • Be prepared to treat the patient on a day-to-day basis because every day can be a day of progression and/or setbacks. Be ready for anything.
    • Interdisciplinary communication between medical team, occupational therapy and speech therapy.
    • We can provide education for the patients and their support systems.
    • Maintain a positive attitude and optimistic outlook.
  • It’s important to know that CIDP is a unique diagnosis to each and every patient. (Barohn, et al., 2010)
  • No treatment will be the same, therefore it is important to be aware of their past history, their past and current symptoms, as well as their current lifestyle.
  • There is no specific “cure” that physical therapy can provide, so we make it a goal to use the techniques, exercises and knowledge that we have in order to best improve the quality of the life of the patient.
  • Barohn, et al. Chronic Inflammatory Demylinating Polyneuropathy Disease Activity Status: Recommendations for Clinical Research Standards and Use In Clinical Practice. Journal of the Peripheral Nervous System. 2010; 15(4): 326-333.
  • Forsberg A, Press R, Westblad ME. Disability and health status in patients with chronic infammatory demyelinating polyneuropathy. Disability & Rehabilitation. 2009; 31(9): 720-725.
  • Greenwood R , Tuckey J. Rehabilitation after severe Guillain-Barré syndrome: the use of partial body weight support. Physiotherapy Research International. 2004; 9(2): 96-103.
  • HartungH, JanderS, Kieseier BC, Köller H. Chronic inflammatory demyelinating polyneuropathy. N Engl J Med. 2005; 352: 1343-1356.