Physical therapy intervention with a low frequency of exercise for a patient with a complicated form of hereditary spastic paraplegia: a case report

[Purpose] Hereditary spastic paraplegia (HSP) is a neurodegenerative disorder characterized by progressive spasticity and weakness of the lower limbs. To date, the appropriate frequency and intensity of physical therapy for patients with HSP are not well-known. We created an original rehabilitation program for a patient with a complicated form of HSP, wherein the program required low-frequency involvement to adapt to the long-term insurance system in Japan. We wanted to find out whether this program could maintain the physical functions and activities of daily living (ADL) of the patient. [Participant and Methods] A 41-year-old male diagnosed with a complicated form of HSP with decreased visual acuity and ataxia of the trunk and upper limb underwent a specific rehabilitation program that included a squatting exercise, a kneeling position exercise, and a motion exercise of taking a bath. This intervention program lasted for 20 minutes per session, with a frequency of two days per week. The patient was in the program for 12 weeks. [Results] All outcome measures, including muscle strength (grip force and quadriceps) and Barthel index, remained unchanged at the end of the intervention program. [Conclusion] The original intervention program used in this study, which had a low frequency of exercise, was effective in preventing further regression of the lower limb function of the patient with a complicated form of HSP, and in preventing a decrease in the ability of the patient to perform ADL.