Dados do Trabalho

Título

Adherence to motor rehabilitation can influence the motor trajectories of SMA patients treated with nusinersen

Resumo

Introduction: Patients with 5q-Spinal Muscular Atrophy (SMA) should always undergo treatment with physical therapists in the motor area, but in many cases this happens only after the introduction of drug treatment, but not every increase in the adherence of rehabilitation can be beneficial.
Objective: To evaluate the effects of changing the frequency and increasing adherence of motor physical therapy before or after the introduction of nusinersen.
Methods: Twenty-eight patients with SMA type 1, 2 and 3 were evaluated using the CHOP-INTEND (Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders) and HFMSE (Expanded Hammersmith Functional Motor Scale for SMA) motor function scales. A questionnaire was carried out to identify the frequency and adherence of motor rehabilitation before and after starting treatment with nusinersen, with a 12-month follow-up.
Results and Discussion: In this study it is possible to see that those patients who started physical therapy only after drug treatment with an exaggerated increase in rehabilitation time did not present motor gains, as well as those patients who reduced the time of physical therapy. The greatest gains in the scores on motor scales were presented by patients who had previously performed motor physical therapy for about 3 hours a week, and for those who performed at least 1 hour of motor physical therapy per week and increased by up to 2 hours on average. Disease modifying treatment will not achieve its best result if there is no adequate rehabilitation associated with medication.
Conclusion: It is important to evaluate the frequency and adherence of baseline rehabilitation before starting drug treatment. Therefore, it is possible to plan a change in physical therapies frequency after treatment, thus avoiding fatigue and risk of motor loss.