Physical therapy is a very productive option for those that suffer from Chronic Inflammatory Demyelinating Polyneuropathy. When engaging in this type of treatment, patients will find that their function is maximized, pain is reduced, muscle atrophy is prevented, and balance is improved. All of this will work together to aid in your mobility and your overall safety. In this guide, you will learn the benefits of physical therapy in treating Chronic Inflammatory Demyelinating Polyneuropathy.
What is Chronic Inflammatory Demyelinating Polyneuropathy?
CIDP is a type of demyelinating disease that is acquired and involves peripheral nerves. In most instances, it is considered to be the counterpart to the illness known as Guillain-Barre syndrome. In fact, about 16% of all individual that have this condition also present with GBS. In less than two months’ time, those with this condition usually develop symmetrical-based weakness, issues with balance, reflexes that diminish over time, sensory-based changes, and impaired sensations.
When a person has CIDP on a long-term basis, there will be abnormalities in their gait, in social-based and psychological-based functioning. The prognosis when one is diagnosed with this condition is dependent upon the age when diagnosed, the course of treatment, the response to the treatment received, and the findings that are electro physiological in nature.
What is the Pathophysiology of CIDP?
CIDP is a disease that is located in the peripheral nervous system. On the outside of the nerves of the peripheral nervous system is a fatty layer of myelin that is white in color and is composed of glial cells. These are also referred to as “Schwann Cells”. The coating that is created by these cells help the axons then to transmit neural impulses more quickly. These are transported to receptor sites – which include the muscles and the organs within the body.
First, the myelin that is located around the nerves is completely destroyed – which causes changes and starts the process of denervation within the supplied muscles. The nerves that are affected start to demonstrate a segmental-based infiltration with inflammatory cells, called “lymphocytes”. Demyelination also starts to infiltrate on a segmental basis. Soon, the Schwann cells proliferate and there is a deposition of collagen. This causes the thickening of the nerve and results in an appearance that is similar to that of an onion bulb.
What Causes Chronic Inflammatory Demyelinating Polyneuropathy?
CIDP is an autoimmune disorder of the body. It involved humoral immune-based mechanisms and the T-cells of the body and targets the myelin of the peripheral nervous system. It is considered to be idiopathic; however, it also has variants that may be associated with neoplastic process, infections associated with HIV, as well as a history of type 2 diabetes.
How Many People Have CIDP?
The prevalence of this condition has been reported as few as 0.8 per 100,000 up to 8.9 per 100,000. The risk for suffering from this condition varies and advances with age. The peak age in which this is commonly experienced is as young as 40 years old to as old as 60 years old. It seems to affect males more than females. It is believed that many more people experience this condition than is known, but it is believed that the condition is not reported as most other medical conditions. It is believed that there are inconsistencies with the diagnosing criteria.
What are the Most Common Symptoms of Clinical Presentation with CIDP?
When patients present with CIDP, there are several symptoms that may be experienced. The following outlines the most common:
- Problems with Walking
- Stair Climbing Difficulties
- Balance Dexterity
- Manual Dexterity
- Sensory Loss
- Symmetric Weakness in the Limbs
- Numbing Sensations
- Buzzing Sensations in the Body
- Neuropathic Pain
- Sensory Complications
What are the Major Features of CIDP?
- Symptoms Progress Over Two Months
- Motor Symptoms Becoming Predominant
- A Reduction in Reflexes of the Deep Tendons
- Evidence of Issue in Nerve Conduction Tests
- Symmetric-Based Involvement of the Legs and the Arms
- Involvement of Both Distal and Proximal Muscles
- The Presence of Cerebrospinal Fluid Protein Elevation
What are the Main Differential Diagnoses of CIDP?
There are several different types of differential diagnoses associated with CIDP. The following outlines the main or most common ones:
- Multiple Sclerosis
- Guillain-Barre Syndrome
- Diabetic Polyneuropathy
- Neuropathy
- Multifocal Motor Neuropathy
- Amyotrophic Lateral Sclerosis (ALS)
- Fibromyalgia
- Nutritional Deficiencies
- Systemic Inflammatory Diseases
- Toxins
- Critical Illnesses
How is Chronic Inflammatory Demyelinating Polyneuropathy Diagnosed?
The diagnosis of CIDP is an extensive process that includes both an inpatient and an outpatient team of professionals. Individuals that are required to make the diagnosis includes a neuromuscular professional, a neurologist, pain management specialist, psychiatrist, a physical therapist, intensivist, and others. It could take months to years for a patient to receive an official diagnosis as so many other conditions and diseases must be ruled out.
What Role Does a Physical Therapist Play in the Treatment of CIDP?
A physical therapist’s role to the treatment of an individual that has CIDP is specialized to each patient that has the condition. Those that specialize in physiotherapy prescribe aids for the gait that help with the person’s balance and their movements. It is very common for patients with this condition to have issues with balance, walking, gait, and exercising. As a result of this, the exercise regimens used by patients must be tailored on an individual basis. This way, overexertion does not happen. Physical therapy helps in the following ways:
- The special exercises ordered by the physical therapist are designed to help with balance and mobility. They help with coordination, stability, improving the gait, and help in reducing the risks of falls.
- Physical therapy helps a patient build up their muscle strength and overall endurance. Because of this, atrophy is prevented and cardiovascular fitness is improved up to a total of 30%.
- Physical therapy helps in both pain management and fatigue management. Examples of the activities that help in these areas include stretching exercises, energy conservation activities, and others.
- Physical therapy helps a patient with CIDP become functionally independent. This may include providing a patient with a brace, a walking cane, or a walker in order to help make the tasks that they complete on a daily basis easier.
- Physical therapy helps a patient to feel better, overall – both physically and psychologically.
What Should a CIDP Patient Consider When Going Through Physical Therapy?
If you have CIDP, there are many considerations that should be made. These include – but are not limited to – the following:
- First, you should always avoid overexerting yourself. Exercise has the potential to wear you out. This could negatively impact your recovery. If you feel as if you are pushing it, slow down.
- It is best to start treatment early in your diagnosis. In doing so, you will receive the biggest benefits. The good thing about physical therapy is, even if you delay treatment, you will still benefit from it in one way or another.
- Physical therapy is a treatment that may be customized to treat you and the symptoms that trouble you the most. It can be tailored for you as an individual. The exercises may consist of active activities, gravity-reduced, and resistive.
How is Outcome Measured in Those With CIDP?
There are many different ways that outcome is measured in those that have CIDP. The following outlines the most common methods:
- The “TUG” test (Timed up and go Test) – This activity measures that time that it takes to stand up from a sitting position in a chair, walk a short distance, and turn around, go back to the seat and sit down.
- The 10 Meter Walk Test – This test measures the walking speed of the patient.
- Patients are also encouraged to participate in grip tests in order to determine their grip strength.
- The “FSS” test (Fatigue Severity Scale) – This test is used to measure the amount of fatigue that a patient has.
- The “SF-36” test – This test measures the quality of life that the patient experiences. This includes their social and physical functioning, if they experience pain or not and how much. Their general health and vitality are also evaluated.
Conclusion
If you suffer from Chronic Inflammatory Demyelinating Polyneuropathy, it is imperative that you focus on treatment plans that will help you experience relief from the symptoms in which you suffer. The symptoms of the condition are progressive. It results in weakness in the upper and the lower limbs, fatigue, and a poor quality of life. Physical therapy is – by far – one of the most productive treatments for CIDP. If you have this condition and are tired of living a subpar life, contact us here at Back to Motion Physical Therapy today to learn about all of the treatment options that we have that can help you experience a boost to your quality of life. You may reach us by calling the following phone number today or by visiting our website: 303-832-5577