Comparison of two rehabilitation treatments in CMT neuropathy:results at the end

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Comparison of two rehabilitation treatments in Charcot-Marie-Tooth

(CMT)neuropathy: results at the end of therapy and after 6 months of follow up.

A. Schenonel, M. Monti-Bmgadin!, R. Zuccarino!, P. Moretti2

, M. Grosso1, D. Scorsone3, E. Crirni3 , A. Bennicelli!, M. Grandis1 and G.

Magge

IDepaItment of Neurosciences, Ophthalmology and Genetic, 2Department of

Rehabilitation Medicine, 'Department of Internal Medicine, University of Genova,

Italy

Background: the efficacy of rehabilitation and the need for re-treatment in CMT

patients is unclear.

Methods: we compared, in a pilot study on 12 CMT patients, two treatments: 1)

Treadmill, Stretching and Proprioceptive Exercises (TreSPE) vs 2) rehabilitation

standard protocol

(RSP: respiratory, stretching and proprioceptive exercises). Time points: TI

(baseline), T2 (after 3 months of therapy), T3: (after 6 months wash out)

Outcome measures: MRC, Tinetti balance scale (TBS), short battery of lower limbs

performance scale, oxygen consumption

and lung function tests, peak treadmill velocity, peak treadmill slope and Bruce

Protocol.Treadmill Stress Test (BPTST).

Results: MRC did not change after any of the two protocols. The TBS showed a

higher, but not significant, improvement at T2 in TreSPE (l,8 points) than in

RSP (l,4 points). At T3 it slightly worsened in both treatments (- 04 points for

RSP and - 0.25 points for TreSPE) The

short battery of lower limbs performance scale behaved as the TBS. There were no

significant differences of lung function parameters (FEVl, FVC, RV, FRC, MlP,

MEP) in both protocols. Peak treadmill velocity, at T2, increased more in RSP (0

39 mls) than in

TreSPE (018 mls). At T3 no changes were observed in the RSP group, while TreSPE

showed a slight worsening of the maximum speed (0..08 mls) Treadmill slope

increased at T2 in both protocols (standard: +3..6%; TreSPE: + 1 7%) At T3 RSP

patients showed a further increase

in Treadmill slope (04 mls), while TreSPE ones lost 0.75 mls. BPTST at T2

improved more in RSP patients (438%) than in TreSPE ones (22,4%); at T3 RSP

patients had a futher but slight improvement (4,8%) while TreSPE ones reduced

their performance (-8,15%)

Conclusion: we confirm the importance of rehabilitation in CMT patients.

Although there is no evidence to recommend the use of TreSPE vs standard

treatment, both protocols improved.