Vestibular rehabilitation in cerebellar ataxia with neuropathy and vestibular areflexia syndrome(CANVAS)-A case report  

作　　者：R.G.Harrell A.R.Cassidy B.N.Klatt P.Hovareshti S.L.Whitney 

机构地区：[1]School of Health and Rehabilitation Sciences,Department of Physical Therapy,University of Pittsburgh,Pittsburgh,PA,15219,USA [2]Rehabilitation Institute,University of Pittsburgh Medical Center,Pittsburgh,PA,15219,USA [3]BlueHalo,Intelligent Automation,Rockville,MD,20855,USA [4]Department of Otolaryngology,University of Pittsburgh Medical School,Pittsburgh,PA,15219,USA [5]The University of Pittsburgh,Department of Physical Therapy,100 Technology Dr.Pittsburgh PA 15219

出　　处：《Journal of Otology》2023年第4期199-207,共9页中华耳科学杂志（英文版）

摘　　要：Background and purpose:Cerebellar ataxia,neuropathy,and vestibular areflexia syndrome(CANVAS)is a neurodegenerative disease of the cerebellum.The disease progression is slow,with up to 25%of people diagnosed needing to use a wheelchair after 15 years from diagnosis.Vestibular symptoms arise from centrally-mediated ocular movement degradation and the reduced vestibular-ocular reflex functioning bilaterally.To date,no report has shown an improvement in VOR gain or gait outcome measures in someone with CANVAS after a course of vestibular physical therapy.Case description:A 65-year-old male,Patient X,first noticed symptoms in his fourth decade of life and was diagnosed with(CANVAS)in his seventh decade.Patient X reported numbness and tingling in his hands and feet,decreased ability to perform daily activities,and several falls.Intervention:Patient X completed a four-month course of vestibular physical therapy,including vestibular ocular reflex exercises,balance training,gait training,and the VestAid application for eye gaze compliance monitoring.The Vestaid application uses eyes and facial recognition software to record the percentage of time that the patient kept their eyes on the target.Outcomes:After vestibular therapy,Patient X had a clinically meaningful improvement in gait speed:from 1.02 m/s to 1.13 m/s and in the Functional Gait Assessment from 20/30 to 27/30.Patient X's eye gaze compliance improved from a median of 43%(range 25e68%)to a median of 67%(58e83%).Discussion:This case study demonstrates that vestibular rehabilitation improved eye gaze compliance and functional outcomes in a person living with CANVAS.

关 键 词：VESTIBULAR NEUROPATHY meaningful 

分 类 号：R764[医药卫生—耳鼻咽喉科]