Disclosures: David Crandell, MD: No financial relationships or conflicts of interest

Objective: To test hypothesis that individuals with Tick-borne Impairment (TBI) benefit from physiatric evaluation, management and rehabilitation services.

Design: Prospective cohort study Setting : Outpatient Rehabilitation Facility Participants : Patients with tick-borne illness represent a growing population for outpatient rehabilitation services in endemic areas of the Northeast, especially Massachusetts. 124 subjects with TBI were seen and followed prospectively for a minimum of 2 years.

Interventions: The General Symptom Burden in Lyme Disease (GSQ -30) was used to assess symptom burden among patients with Post-Treatment Lyme Disease Syndrome and TBI at a outpatient physical medicine and rehabilitation clinic in Boston from 2016 through 2019. Patients completed the GSQ-30 before initial their physiatric evaluation and at all scheduled follow-up appointments with their physiatrist over the study period of 3 years. Patients with TBI, including pain-related mobility and balance impairment, fatigue and encephalopathy, received physiatric-directed rehabilitation services by physical and occupational therapy, and speech language pathologists. Among the rehabilitation interventions utilized were therapeutic exercise, balance training, aquatic therapy, ergonomic assessment, cognitive therapy, and pain management. Patients also received mental health screening and consultation. These services were provided within the hospital network and community rehabilitation providers in the region with a detailed referral.

Main Outcome Measures: Improvement in symptom scores in three core domains: pain, fatigue, and cognition. The GSQ-30 detected significant change in symptom burden after physiatric care initiation and rehabilitation therapy. This change correlated with a reduction in functional impairment.

Results: GSC-30 scoring changes demonstrate improvement in TBI from physiatric care and targeted rehabilitation treatment. Conclusions: Individuals with Tick-borne Impairment (TBI) benefit from physiatric evaluation, management and rehabilitation services. Additional training of PM&R clinicians and rehabilitation teams to the unique needs of this patient population will allow for increased access and improved quality of care.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/rehabilitation-with-tick-borne-illness-the-new-tbi-tick-borne-impairment/