Vinicius T Francio1, Ron Boesch2, Michael Tunning3. 1. Chiropractic Physician, Researcher, OSSO Oklahoma Spine Surgery and Orthopedics - Community Hospital Campus, 3110 SW 89 , Suite 200E Oklahoma City, OK 73159, Palmer Center for Chiropractic Research (PCCR) 741, Brady Street, Davenport, IA 52803. 2. Professor, Faculty Clinician, Dean of Clinics, Palmer Academic Health Center, Palmer College of Chiropractic, 741 Brady Street, Davenport, IA 52803. 3. Assistant Professor, Department of Diagnosis & Radiology, Palmer College of Chiropractic, 1000 Brady Street, Davenport, IA 52803.
Abstract
OBJECTIVE: Posterior cortical atrophy (PCA) is a rare progressive neurodegenerative syndrome which unusual symptoms include deficits of balance, bodily orientation, chronic pain syndrome and dysfunctional motor patterns. Current research provides minimal guidance on support, education and recommended evidence-based patient care. This case reports the utilization of chiropractic spinal manipulation, dynamic neuromuscular stabilization (DNS), and other adjunctive procedures along with medical treatment of PCA. CLINICAL FEATURES: A 54-year-old male presented to a chiropractic clinic with non-specific back pain associated with visual disturbances, slight memory loss, and inappropriate cognitive motor control. After physical examination, brain MRI and PET scan, the diagnosis of PCA was recognized. INTERVENTION AND OUTCOME: Chiropractic spinal manipulation and dynamic neuromuscular stabilization were utilized as adjunctive care to conservative pharmacological treatment of PCA. Outcome measurements showed a 60% improvement in the patient's perception of health with restored functional neuromuscular pattern, improvements in locomotion, posture, pain control, mood, tolerance to activities of daily living (ADLs) and overall satisfactory progress in quality of life. Yet, no changes on memory loss progression, visual space orientation, and speech were observed. CONCLUSION: PCA is a progressive and debilitating condition. Because of poor awareness of PCA by physicians, patients usually receive incomplete care. Additional efforts must be centered on the musculoskeletal features of PCA, aiming enhancement in quality of life and functional improvements (FI). Adjunctive rehabilitative treatment is considered essential for individuals with cognitive and motor disturbances, and manual medicine procedures may be consider a viable option.
OBJECTIVE:Posterior cortical atrophy (PCA) is a rare progressive neurodegenerative syndrome which unusual symptoms include deficits of balance, bodily orientation, chronic pain syndrome and dysfunctional motor patterns. Current research provides minimal guidance on support, education and recommended evidence-based patient care. This case reports the utilization of chiropractic spinal manipulation, dynamic neuromuscular stabilization (DNS), and other adjunctive procedures along with medical treatment of PCA. CLINICAL FEATURES: A 54-year-old male presented to a chiropractic clinic with non-specific back pain associated with visual disturbances, slight memory loss, and inappropriate cognitive motor control. After physical examination, brain MRI and PET scan, the diagnosis of PCA was recognized. INTERVENTION AND OUTCOME: Chiropractic spinal manipulation and dynamic neuromuscular stabilization were utilized as adjunctive care to conservative pharmacological treatment of PCA. Outcome measurements showed a 60% improvement in the patient's perception of health with restored functional neuromuscular pattern, improvements in locomotion, posture, pain control, mood, tolerance to activities of daily living (ADLs) and overall satisfactory progress in quality of life. Yet, no changes on memory loss progression, visual space orientation, and speech were observed. CONCLUSION: PCA is a progressive and debilitating condition. Because of poor awareness of PCA by physicians, patients usually receive incomplete care. Additional efforts must be centered on the musculoskeletal features of PCA, aiming enhancement in quality of life and functional improvements (FI). Adjunctive rehabilitative treatment is considered essential for individuals with cognitive and motor disturbances, and manual medicine procedures may be consider a viable option.
Entities:
Keywords:
chiropractic; neurodegenerative disease; physical and rehabilitation medicine; spinal manipulation
Authors: Luis Garcia-Larrea; Joseph Maarrawi; Roland Peyron; Nicolas Costes; Patrick Mertens; Michel Magnin; Bernard Laurent Journal: Eur J Pain Date: 2005-12-09 Impact factor: 3.931