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Hebb C, Raynor G, Perez DL, Nappi-Kaehler J, Polich G. The use of rhythmic auditory stimulation for functional gait disorder: A case report. NeuroRehabilitation 2022; 50:219-229. [DOI: 10.3233/nre-228005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Functional gait disorders (FGD) are a common and disabling condition. Consensus-based rehabilitation techniques for treating FGD and other functional neurological disorder presentations at large utilize a variety of therapeutic strategies, including distraction, novel approaches to movement, entrainment, stress/hypervigilance modulation, and psychotherapy. CASE REPORT: Here we present a case of a 24-year-old woman with a complex history of anxiety, depression, left frontal astrocytoma, postural orthostatic tachycardia syndrome (POTS) and FGD. During a multidisciplinary inpatient rehabilitation stay for FGD, the patient underwent rhythmic auditory stimulation (RAS) delivered by a neurologic music therapist in conjunction with physical therapy, occupational therapy, and psychotherapy. RESULTS: The RAS intervention appeared to play a significant role in symptom resolution for this patient. Improvement in the patient’s truncal displacement, foot dragging, and well as overall gait speed occurred following serial RAS trials performed over a single treatment session. Benefits persisted immediately following the intervention and upon subsequent reassessment. Although at four-year follow-up the patient’s FGD symptoms remained resolved, fatigue continued to limit her ambulatory capacity and overall endurance. CONCLUSION: RAS represents a unique therapeutic approach for treating FGD, complementary to existing consensus-based rehabilitation recommendations, and may warrant further consideration by the field.
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Affiliation(s)
- Caitlin Hebb
- MedRhythms, Inc., Boston, MA, USA
- Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Geoffrey Raynor
- Department of Psychiatry, Brigham’s and Women’s Hospital, Boston, MA, USA
| | - David L. Perez
- Department of Neurology and Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | | | - Ginger Polich
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Brigham’s and Women’s Hospital, Boston, MA, USA
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