Application Of A Balance Training Program In A Patient With Charcot Marie Tooth Disease: A Case Report

Background and Purpose: Charcot Marie Tooth Disease (CMT) is the most common progressive inherited neurological disorder1. Characteristics include muscle weakness and reduced sensation beginning in the distal lower extremities. Individuals with CMT have increased difficulty sensing and maintaining balance. There is minimal research on the effectiveness of balance training and outcome measures in this population. The RUSK Hospital Modified Romberg Protocol (RUSK MRP) is used as a balance-training program for patients with a neurological diagnosis, however no information is available on its effectiveness in CMT. The purpose of this case report was to investigate the effectiveness of the RUSK MRP in a patient with CMT. Case Description: The patient was a 60-year-old male diagnosed with CMT over 40 years ago and reported more than seven falls in the last six months. The RUSK MRP intervention included balance training with foot placement variation, surface type and visual cues as well as strengthening and mobility training (See Appendix A) twice a day for seven days over 12 weeks. Outcomes: The patient demonstrated improvement in balance per Berg Balance Scale score from 31 at initial evaluation to 41 at discharge. RUSK MRP balance improved from 20 seconds at six inches apart to ¾ Romberg for 1 minute (See Appendix A). Discussion: CMT can be a debilitating disease that causes significant balance challenges. The RUSK MRP was found to be successful in the treatment and outcome evaluation of a 60-year-old patient with CMT. Although the patient made improvements in his balance, further research is needed to assess the validity and reliability of the RUSK MRP