The Effects of a Balance Training Program on Fall Risk of a Patient with a Rare Neurodegenerative Movement Disorder: Neuroferritinopathy- a Case Report

Research Objectives: To determine the outcome of a home-based balance training program in the frequency of falls, balance, and balance confidence of a patient with Neuroferritinopathy

Design: Prospective Intervention Case Report

Setting: Home-Health

Participants: A patient diagnosed with Neuroferritinopathy identified as home-bound and high fall risk.

Interventions: Balance training for 45 minutes twice a week for 8 weeks. The program is divided into: (1) supervised balance training, (1) unsupervised home exercises, and (3) patient/caregiver-related instruction. The supervised balance training was designed to address static, dynamic, anticipatory, and reactive postural control. Static balance exercises required the patient to maintain her balance in static standing positions with manipulation of vision and somatosensation. Dynamic balance exercises required the patient to maintain her balance while performing functional tasks, which were derived from the balance retraining part of the Otago Exercise Program. Anticipatory control exercises required the patient to maintain balance during a predicted disturbance like the following activities: STS, reaching, and stepping in different directions. Perturbation-based training was done to improve reactive postural control.

Main Outcome Measures: Berg Balance Scale (BBS), Timed Up and Go (TUG), Activities-specific Balance Confidence (ABC) scale

Results: After 8 weeks, the patient demonstrated the following: report of decreased number of falls; gains in BBS indicating decrease in fall risk and improved static, dynamic, and anticipatory balance control; decrease in TUG time which implicates improved functional mobility and balance during gait, and; improved balance confidence shown by the ABC scale.

Conclusions: The outcomes demonstrated a decrease in fall risk. This does not guarantee elimination of future falls since the high-risk factors are still present. Results of this case report cannot be used as a sole basis in treating patients with NF or movement disorders with parkinsonism; however, clinicians may use this for guidance when they treat patients with similar clinical manifestations.

Author(s) Disclosures: No conflict of interest to disclose