Date of Award

2018

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Michelle LaBrecque

Keywords

West Nile Fever -- rehabilitation; Case Reports

Abstract

Background and Purpose. West Nile Virus (WNV) is a neurotropic virus capable of causing damage of varying severity. WNV is commonly transmitted to humans from mosquitoes and is most prevalent in the months of August and September due to the method of transmission. The WNV can produce mild systemic symptoms classified as West Nile Fever (WNF). However, it can progress and infiltrate the nervous system, at which point the virus is categorized as neuroinvasive. One classification is West Nile Meningitis (WNM) that involves infection and inflammation of the meninges or coverings surrounding the brain and spinal cord. There is currently a limited amount of research related to the presentation and treatment of West Nile Meningitis. The purpose of this case study is to show the potential benefits of physical therapy intervention in order to increase the rate of functional recovery in patients with WNM.

Case Description. This case study describes the outpatient physical therapy interventions for an adult female recovering from West Nile Meningitis. The patient presented with poor dynamic balance, decreased coordination, decreased endurance, movement patterns similar to parkinsonism, rigid gait pattern, inability to dual-task, impulsivity and flat affect.

Intervention. The patient completed five weeks of outpatient physical therapy. Activities addressed her movement impairments and deconditioning. Exercises were related to strength, coordination, and functional balance with cognitive task integration.

Outcomes. The patient returned to work and independent living eight weeks after initial transmission. The patient showed clinically significant improvement on her MiniBESTest scores. She achieved near-baseline functional recovery in significantly less time than previous studies reported.

Discussion. Physical therapy intervention and an exercise program to address deconditioning and movement disorders in patients with West Nile Meningitis may significantly increase the rate of functional recovery. Although the primary pathology revolves around the central nervous system, it is important to remember the physical impairments associated with this condition. Physical therapy should be considered an integral part of treatment for cases of West Nile Meningitis.

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