Improvement in gait and functional abilities in an adult with posterior cortical atrophy after translingual neuromodulation with neurorehabilitation physical therapy: a case report.

Abstract

Background: Posterior cortical atrophy (PCA) is a neurodegenerative syndrome characterized by progressive damage to the brain's visual and association areas, resulting in impaired spatial awareness, visual processing, and functional independence.

Purpose: This report examines the effects of a 14-week treatment protocol consisting of translingual neuromodulation via a portable neuromodulation stimulator (PoNS_®¹) in conjunction with physical therapy on balance, gait, and functional mobility in an adult male with PCA.

Case description: Assessments included objective and subjective measures of balance and gait - the 10-Metre Walk Test, Functional Gait Assessment (FGA), Dynamic Gait Index (DGI), Community Balance and Mobility Scale (CB&M), Neuro-Quality of Life (Neuro-QoL), and Activities-specific Balance Confidence (ABC) Scale. These were performed at baseline and weeks 4, 8, and 14 to evaluate the protocol's efficacy in improving balance, stability, and gait.

Outcomes: Postural stability, balance, gait patterning, and gait speed improved, enhancing daily functioning abilities and self-confidence. Gait speed improved by 0.48 m/s (comfortable) and 0.46 m/s (fast), exceeding MDC thresholds. The participant's FGA score increased 21 points and DGI increased 17 points, both exceeding their respective MDC thresholds (6 points for FGA, 3.2 points for DGI), reflecting marked gait improvements. The CB&M score rose 24 points, exceeding the MDC of 9.6 points. Despite these gains, gait speed remained below age-related norms.

Conclusion: Given the largely positive response to the protocol, further investigation should be undertaken to continue to explore the efficacy of PoNS_® and physical therapy to determine its viability as a treatment for symptoms of PCA.