Objective: To describe the frequency and characteristics of Uhthoff's phenomenon and its association to fatigue in spinal optical MS patients, and to evaluate quality of life and depression. Methods: MFIS-BR scale, Beck's depression inventory, quality of life SF-36 scale and a questionnaire based of FDS elaborated by the authors on the influence of heat on fatigue, visual dysfunction and other neurological manifestations were applied. Results: The final sample consisted of 32 patients and 29 healthy individuals. Uhthoff's phenomenon was found in 31.25% and fatigue on 30% of patients, with significant difference between the groups (6.9%; p=0.018). Strong positive correlation was found between fatigue and depression, and vitality of quality of life domain obtained a higher negative correlation to fatigue. There was no association between fatigue and Uhthoff's phenomenon. Conclusion: Uhthoff's phenomenon is present in 1/3 of spinal optical MS patients and is associated to the number of visual events (optical neuritis). Heat mainly worsens fatigue and induces temporary visual dysfunctions in MS. Fatigue is associated to depression and negative impact in quality of life.
Background and Purpose: Young-onset Parkinson disease (YOPD) is characterized by an age of onset before 40 years and slower disease progression. Lee Silverman Voice Treatment (LSVT) BIG is an amplitude-based treatment performed to decrease symptoms of Parkinson disease (PD), administered inperson by certified physical and occupational therapists utilizing standardized exercises and patient goaldriven activities. Telehealth services allow for patient and clinician interaction when barriers exist for the delivery of traditional healthcare services. The goal of this case report was to investigate the effectiveness of LSVT BIG treatment delivered via telehealth. Case Description: LSVT BIG treatment was delivered via telehealth to a 46-year-old male with Hoehn and Yahr Stage II YOPD who was unable to access an LSVT BIG certified clinician in a rural area. Doctor of physical therapy students who had completed LSVT BIG certification training were supervised by an LSVT certified physical therapist. Maximal daily exercises, functional tasks, a hierarchy task, and BIG walking were performed via telehealth over the course of four weeks with focus on high intensity and modeling big movements. Initial, discharge, and six month follow-up examinations were performed inperson.Outcomes: Following completion of LSVT BIG via telehealth, the patient improved 9 Hole Peg for dominant hand, mini-BESTest, 10 Meter Walk Test, 30 second Sit to Stand, and UPDRS III scores. At the six-month re-evaluation, the patient improved or maintained mini-BESTest, 30 second Sit to Stand, and UPDRS III scores. Subjectively, the patient reported increased amplitude in daily movement patterns, improvements in gait, tremor, voice volume, typing, handwriting, energy level, and ability to think big. Conclusion: Investigation into the effectiveness of providing physical therapy interventions via telehealth is imperative, now more than ever, as we navigate a global pandemic. This case report suggests that LSVT BIG delivery via telehealth may be effective for treatment of YOPD. Telehealth services could increase access to physical therapy treatment for patients with Parkinson disease. Further research on the delivery of LSVT BIG via telehealth is warranted.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.