Physical therapy for a patient with neuromyelitis optica during the acute phase: A case report

This case report explores the safety of physical therapy during the acute phase for a patient with neuromyelitis optica (NMO), an inflammatory disorder affecting the optic nerve and spinal cord. The patient, a 32-year-old female, experienced left hemiplegia and limb sensory disorder due to NMO. The patient underwent a physical therapy program that commenced on day 4 of hospitalization, involving exercises like muscle strength training, electrical muscle stimulation, and gait practice. The therapy was cautiously supervised to avoid exacerbating symptoms. The patient's condition improved with physical therapy; muscle strength increased, and the Expanded Disability Status Scale (EDSS) score improved from 9.0 to 6.0. This suggests that physical therapy can be safely and effectively applied during the acute phase of NMO under careful supervision.

• 1
  Initiating physical therapy early, specifically on day 4 of admission, did not worsen the patient's symptoms. This suggests that concerns about exacerbating symptoms during the acute phase may be mitigated with careful supervision.
• 2
  The patient's muscle strength improved significantly, progressing to approximately grade 4 by a manual muscle test. This improvement demonstrates the potential for regaining motor function through physical therapy during the acute phase.
• 3
  The patient's EDSS score decreased from 9.0 to 6.0, indicating a substantial improvement in overall disability status. This improvement highlights the effectiveness of the physical therapy program in enhancing the patient's functional abilities.