HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Miller, N. H Articles by Goldberg, J. L Search for Related Content PubMed PubMed Citation Articles by Miller, N. H Articles by Goldberg, J. L

Physical Therapist Examination, Evaluation, and Intervention for a Patient With West Nile Virus Paralysis

NH Miller, MD, is Assistant Professor of Pediatrics, Department of Pediatrics, Baystate Medical Center, Springfield, Mass. Address all correspondence to Dr Miller at Baystate Children’s Hospital, General Pediatrics and Adolescent Medicine, 3300 Main St, 4th Floor, Springfield, MA 01199 (USA)
DJ Miller, PT, PhD, is Professor and Chair, Department of Physical Therapy, Springfield College, Springfield, Mass
JL Goldberg, PT, BS, is Physical Therapist, Neurologic and Orthopedic Rehabilitation Center at Mapleton, Boulder Community Hospital, Boulder, Colo

(Nancy.Miller{at}bhs.org)

Background and Purpose. The incidence of West Nile virus (WNV) has increased in the United States since 1999. A small percentage of people with WNV develop West Nile neuroinvasive disease (WNND) with encephalitis and flaccid paralysis. The purpose of this report is to describe the physical therapist management and outcomes for a patient with WNND and the therapist’s efforts to use an evidence-based practice approach in the management of a patient with this disease. Case Description. The patient was an active 55-year-old woman in excellent health who became acutely ill with asymmetrical lower-extremity weakness. The physical therapist reviewed the available literature, consulted with medical and physical therapist experts and the patient, and elected to use a poliovirus "period of recovery" approach combining intensive strengthening and monitoring of fatigue. Outcomes. The patient progressed from an initial nonambulatory status to ambulation with a single-point cane at week 18 after onset of symptoms. She began to ambulate without an assistive device by week 20. The patient returned to work part-time by week 22 and full-time by week 43. Discussion. These outcomes demonstrate the recovery of a patient with WNND after an intensive strengthening program.

Key Words: Arbovirus • West Nile virus