| Autor: |
de Sire A; Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro 'Magna Graecia', 88100 Catanzaro, Italy., Moggio L; Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro 'Magna Graecia', 88100 Catanzaro, Italy., Marotta N; Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro 'Magna Graecia', 88100 Catanzaro, Italy., Fortunato F; Institute of Neurology, Department of Medical and Surgical Sciences, University of Catanzaro 'Magna Graecia', 88100 Catanzaro, Italy., Spalek R; Rehabilitation Unit, 'Mons. L. Novarese' Hospital, 13040 Vercelli, Italy.; Department of Geriatrics, Neurosciences, Orthopedics, Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, 00168 Rome, Italy., Inzitari MT; Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro 'Magna Graecia', 88100 Catanzaro, Italy., Paolucci T; Physical Medicine and Rehabilitation, Department of Oral, Medical and Biotechnological Sciences, Physical Medicine and Rehabilitation, University G. D'Annunzio, 66100 Chieti, Italy., Ammendolia A; Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro 'Magna Graecia', 88100 Catanzaro, Italy. |
| Abstrakt: |
Multiple sclerosis (MS) represents a major cause of chronic neurological disability in young adults and can result in upper limb sensorimotor impairment with a huge impact on manual dexterity and activities of daily living. Moreover, pain is common in MS and a large proportion of patients suffer from central neuropathic pain. To date, no rehabilitative treatment has been described as useful for these patients. A 46-year-old woman, affected by relapsing-remittent MS, described a one-year history of right shoulder pain (Visual Analogue Scale = 8) that started gradually and without trauma. The patient also presented balance and gait impairments, upper limb strength deficit, and fatigue (Expanded Disability Status Scale = 5.5). A multidisciplinary treatment was proposed, including three intra-articular corticosteroid injections and one month of manual therapy, three sessions/week, based on proprioceptive neuromuscular facilitation for the upper limb. At the end of the rehabilitative treatment, pain relief and an improvement in the range of motion of the affected shoulder, upper limb muscle strength, and hand dexterity were observed. The present paradigmatic case report with literature review demonstrated that a multidisciplinary approach seems to be effective in pain relief in a patient with central neuropathic shoulder pain and relapsing-remitting MS. |
