Clinical case 15
Stabilisation and restored functional independence in a parkinsonian syndrome
man, 78 · Italy
Patient record
- Patient
- man, 78
- Country
- Italy
- Diagnosis
- parkinsonian syndrome with postural instability and motor, cognitive and communicative impairment
- Main features before treatment
- impaired balance, episodes of falling, the need for additional support when walking, stiffness mainly in the right limbs, reduced physical endurance, reduced general activity, reduced cognitive and communicative activity
- Treatment given
- an individual combined cell, immunoregulatory and neuroregenerative programme
- Course after treatment
- stabilisation and an end to the previous deterioration, greater endurance, steadily improving walking to the point of giving up the stick, less stiffness, improved cognitive function and communication with the family
History
By the time he came to us, the parkinsonian syndrome was already affecting the patient's motor independence and daily activity substantially.
Impairment of balance and steadiness on walking gradually increased and he fell from time to time. He began to use a walking stick to move about more safely.
At the same time stiffness of movement increased, mainly in the right limbs. His physical endurance declined: he could cover shorter and shorter distances and tired more quickly under ordinary exertion.
The changes were not confined to movement. His family began to notice that he was becoming less active in conversation, started talking of his own accord less often, interacted less with those close to him and was generally less engaged in daily life.
Before treatment
The patient's main problems were:
- impaired balance
- unsteadiness when walking
- episodes of falling
- the need to use a walking stick
- stiffness of movement, more marked on the right
- reduced physical endurance
- restricted independent motor activity
- reduced initiative overall
- declining cognitive activity
- less conversation and interaction with the family
The main aims of the programme were to stabilise a progressive condition, preserve independent mobility and improve the patient's motor, cognitive and social activity as far as possible.
The programme
A personalised combined programme of cell, immunoregulatory and neuroregenerative therapy was drawn up for the patient.
The programme included several complementary directions aimed at preserving the functional reserve of the nervous system, supporting motor function and then getting the patient more active.
The exact doses, the sequence of procedures and the technical parameters formed part of an individual internal protocol.
An important part of the follow-up was a gradual widening of physical activity: the patient was given advice on regular exercise and on physical activity he could do himself, matched to what he was currently able to manage.
Course after treatment
After the programme the positive change developed in stages, as the patient's functional capacity widened.
Disease stabilisation
One of the most important results was that the previous clinical deterioration stopped.
Over the follow-up period the patient and his family no longer noticed a further steady decline in motor or in cognitive and communicative function.
Physical endurance
One of the first noticeable changes was increased physical endurance.
The patient was able to stay active for longer, cover greater distances and tire less under everyday exertion.
This made it possible to increase the amount of physical activity he did on his own.
Walking
The improvement in walking developed step by step.
At first the patient began to walk more on his own, still using the stick for additional steadiness.
As his endurance and confidence in movement grew, he began to do the recommended exercises regularly.
His dependence on additional support then decreased to the point where he stopped using the stick routinely and began to walk without it.
For the patient and his family this became one of the most visible functional results of the treatment.
Stiffness
A reduction in stiffness of movement was also noted.
Movement became freer and the sense of restriction and difficulty in ordinary activities lessened.
Cognitive function
The family noted positive change in cognitive activity.
The patient became more engaged with what was going on around him, responded more actively, held his attention better and showed more initiative of his own.
Communication and social activity
One of the changes the family found especially striking was the improvement in communication.
Before treatment the patient had become increasingly withdrawn and talked to his family considerably less.
After the programme he became more sociable, started conversations of his own accord more often, kept them going more actively and interacted more with those close to him.
For the family this felt like the return of a substantial part of the patient's former social life.
Outcome
After the individual programme the most significant results were:
- stabilisation and an end to the previous progression;
- increased physical endurance
- a gradual widening of independent walking
- the ability to carry out the recommended exercises
- a steady reduction in dependence on the stick, to walking without support;
- less stiffness of movement
- improved cognitive function
- greater general activity
- marked improvement in communication and interaction with the family.
What is particularly important in this case is the sequence of the functional recovery: first the patient became able to tolerate more exertion and to walk more, then he could do the recommended exercises more actively, and afterwards his dependence on additional support fell considerably.
At the same time the positive changes reached the cognitive and communicative sphere: the patient became more active, more engaged and more sociable, which had a substantial effect on his daily independence and on his life with his family.
This case is described from the patient's medical records and observation over the period after the programme. No personal data is published. The course of the disease and the response to treatment differ from patient to patient.