Disclosures: Roozbeh A. Ahmadi, MD: Nothing to disclose

Case Description: Patient was admitted to Acute Care Hospital due to incoordination and impairments in activities of daily living and walking. He had chorea for 3.5 years with involuntary movements on both upper and lower extremities, which had worsened in the past 3 months. He was treated with IV Immunoglobulin x 2 doses and Methotrexate weekly. He was then transferred from Acute Hospital to IRF. During his IRF stay, his physical therapy and occupational therapy sessions included the use of weights application on his extremities and closed kinematic chain exercises. Involuntary movements on bilateral upper and lower extremities that crossed the body midline and lateral side of the body were recorded at rest, for 1 minute and 5 minutes. Involuntary movements were recorded when weights were applied to the distal extremities, during performance of upper extremity ergometer exercise, and recumbent stepper of lower extremities. He was later started on Tetrabenazine once this medication was available.

Setting: Inpatient Rehabilitation Facility

Patient: A 67-year-old Caucasian male with idiopathic autoimmune chorea.

Assessment/Results: For the upper extremities 12-14 involuntary movements/minute were recorded at rest, 0/min with weights, 0/min while doing upper extremity ergometer. For the lower extremities 10-14 involuntary movements/minute were recorded at rest, 0/min with weights, 0/min while doing recumbent stepper. IRF stay was 14 days. Total FIM was 86 on admission, 116 on discharge. FIM change per day was 2.14.

Discussion: The results show that the patient had improvement in his involuntary movements with the application of weights and during closed kinematic chain exercises.

Conclusion: This case demonstrates that weights application and closed kinematic chain exercises are rehabilitation strategies that can be utilized to improve involuntary movements in patients with idiopathic autoimmune chorea.

Level of Evidence: Level V

« Back to AAPM&R Annual Assembly 2019

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/effect-of-weights-application-and-closed-kinematic-chain-exercises-on-involuntary-movements-in-a-patient-with-idiopathic-autoimmune-chorea-a-case-report/