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Neuromyelitis optica spectrum disorder (NMOSD) can be effectively managed with physical therapy, according to a new case report published in the Bulletin of Faculty of Physical Therapy

The case is that of a 13-year-old female with neuromyelitis optica (NMO). The symptoms of the patient included weakness on the left side and problems with balance and gait.

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She was given an exercise protocol lasting 2 weeks, which included progressive resistance training to improve her strength, virtual reality gaming to improve her balance and stability, and modified constraint-induced movement therapy to improve the functioning of her arms as well as her activities of daily living.

The researchers analyzed outcome measures before and after the exercise program and found that her scores improved in all outcome measures after the intervention. These included manual muscle testing for strength, ProKin TecnoBody assessment for balance and stability, and Functional Independence Measure and Capabilities of Upper extremity Questionnaire for activities of daily living. 

“This case report showed physical therapy is effective in improving muscle strength, balance, gait impairments, and [activities of daily living] in patients with NMO,” the researchers concluded.

“However, there is a need for further studies focusing on the role of physiotherapy in the management of NMO, and the inclusion of recent technologies like virtual reality, and TecnoBody needs to be addressed with better outcome measures for the study.”

NMOSD is a rare chronic inflammatory central nervous system disease characterized by optic neuritis and myelitis. The symptoms of NMOSD include ocular pain, vision loss, numbness or weakness in the arms or legs, loss of balance, dizziness, abnormal sensations such as pins and needles, and problems with bowel and bladder control. 

There is currently no cure for NMOSD, and a multidisciplinary team is required for its management. 


Chakraverty S, Dutta S, Das H. Effects of physical therapy intervention in the management of neuromyelitis optica: a case report. Bull Fac Phys Ther. Published online January 3, 2023. doi:10.1186/s43161-022-00111-w