The combined effect of cranial-nerve non-invasive neuromodulation with high-intensity physiotherapy on gait and balance in a patient with cerebellar degeneration: a case report

Andisheh Bastani; L Eduardo Cofré Lizama; Maryam Zoghi; Grant Blashki; Stephen Davis; Andrew H Kaye; Fary Khan; Mary P Galea

doi:10.1186/s40673-018-0084-z

The combined effect of cranial-nerve non-invasive neuromodulation with high-intensity physiotherapy on gait and balance in a patient with cerebellar degeneration: a case report

Cerebellum Ataxias. 2018 Mar 5:5:6. doi: 10.1186/s40673-018-0084-z. eCollection 2018.

Authors

Andisheh Bastani^{1

2}, L Eduardo Cofré Lizama^{1

2}, Maryam Zoghi³, Grant Blashki⁴, Stephen Davis⁵, Andrew H Kaye⁶, Fary Khan^{1

2

4}, Mary P Galea^{1

2}

Affiliations

¹ 1Department of Rehabilitation Medicine, Royal Melbourne Hospital, RMH-Royal Park Campus, 34-54 Poplar Rd Parkville, Melbourne, VIC 3052 Australia.
² 2Australian Rehabilitation Research Centre (ARRC), Royal Melbourne Hospital, Melbourne, Australia.
³ 3Department of Rehabilitation, Nutrition and Sport, La Trobe University, Bundoora, Melbourne, Australia.
⁴ 4The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia.
⁵ 5Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.
⁶ 6Department of Surgery, The University of Melbourne, Melbourne, Australia.

Abstract

Background: Cranial-nerve non-invasive neuromodulation (CN-NINM) using the portable neuromodulation stimulator (PoNS™⁾ device has been proposed as a novel adjuvant intervention to improve efficacy of gait and balance. This device modulates input and output signals during motor tasks which prompts neuroplastic changes. In this study, we investigated the efficacy of physiotherapy using the PoNS™ in a case with cerebellar degeneration.

Case presentation: The PoNS™ was used during a high-intensity physiotherapy programme delivered over 2 weeks (2 × 1.5 h sessions daily). Clinical and instrumented gait and balance tests were applied pre- and post-intervention.

Results: The patient improved in all tests without any adverse effects.

Conclusion: This study showed the efficacy and feasibility of combined high-intensity physiotherapy and CN-NINM for gait and balance rehabilitation. Further studies should explore CN-NINM effects in larger and more diverse samples of neurological patients.

Keywords: Neuroplasticity; Portable neuromodulation stimulator; Stroke; Tongue stimulator.

Publication types

Case Reports