Combination of Physical Therapy and Baclofen Interventions for Treating an Undiagnosed White Matter Brain Disorder: A Case Report

Abstract

Background and Purpose: Deep and periventricular white matter lesions in the parietal lobe have a negative impact on balance, gait and cognition.  Physical therapy has been shown to be effective in the treatment of neurological conditions by targeting the brain’s neuroplasticity.  Baclofen is a commonly prescribed medication to treat spasticity in the neurological population.  The purpose of this case report is to observe the changes in body impairment and functional abilities of a patient with an undiagnosed cerebral white matter disorder treated with baclofen and physical therapy interventions.

Case Description: The patient is a 54-year-old female who was referred to an outpatient physical therapy clinic by her neurologist for an unknown white matter disorder.  Scores on the SF-36, DGI, Purdue Peg Board, Fugl-Meyer, and Modified Ashworth Scale indicated initial disability.  The patient was seen for 10 visits over 6 weeks and was provided functionally targeted physical therapy interventions as well as oral baclofen by her neurologist.

Outcomes: Patient scores on the SF-36 and DGI showed clinically important improvements in function and general health.

Discussion: This case observed positive functional outcomes with the combination of physical therapy and oral baclofen.  Further research is necessary to determine long-term outcomes as well as appropriate physical therapy dosage and specific exercises.