Date of Award

2016

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Renee Mabey

Keywords

Polyneuropathies -- rehabilitation; Polyneuropathies -- therapy; Case Reports; Diverticular Diseases; Colovesicular Fistula; Sigmoidectomy

Abstract

Background and Purpose: Critical Illness Polyneuropathy/Myopathy results from the presence of sepsis, multi-organ or respiratory failure, septic inflammatory response syndrome, or difficulty weaning from the ventilator. Decreased amplitudes of compound muscle and sensory action potentials, and widespread denervation potentials in muscle are the primary cause for the resultant muscle weakness. The purpose of this paper is to report on the rehabilitation progress in a woman who developed CIP following surgical complications.

Case Description: A 63-year-old woman suffered from critical illness polyneuropathy following a complicated recovery following a sigmoidectomy secondary to diverticular disease. Multiple surgeries, inability to wean from the ventilator, and co-morbidities of obesity and smoking complicated her rehabilitation. Physical therapy rehabilitation included general strengthening, gait, balance and proprioceptive training, and activity modification education.

Outcome: The patient returned home with assistance from family in three weeks. She was discharged with a single point cane and education on activity modification. Improvement, manifested in her AM-PAC and Tinetti functional outcome assessments, supported her discharge home.

Discussion: Following three weeks of intensive physical therapy, the patient was ready for discharge and given the tools to further her rehabilitation to be functionally independent. She returned home with an assistive device and required minimal assistance from her family.

Conclusion: Aggressive physical therapy that targets lower extremity and trunk strengthening, as well as balance and proprioception, and activity modification, is effective treatment for critical illness polyneuropathy.

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