QIM20-133: Rehabilitation of the Amyloidosis Patient

Background: The Comprehensive Amyloidosis Clinic (CAC) at Ohio State University (OSU) is a multidisciplinary clinic for patients to see neurology, nephrology, cardiology, hematology, and physical therapy (PT) in one 3 hour visit. Ultimately, this saves the patient, insurance, and providers’ time and money. Amyloidosis affects different organ systems, Transthyretin amyloidosis (TTR) mainly affects the heart and nerves, causing physical and functional impairments. Currently, specific guidelines for the rehabilitation of amyloidosis patients have yet to be established. OSU has structured specific guidelines to assess functional impairments at diagnosis and throughout treatment to improve quality of life, functional mobility and reduce the risk of decline. This study aims to assess functional limitations and rehab needs of patients with TTR Amyloidosis. Methods: Examination information was gathered by chart review, observation and patient report from the PT evaluation. The evaluation included subjective report of functional limitations, home set up, goals for rehab, range of motion and manual muscle testing. Objective outcome assessments included the Timed Up and Go (TUG) and 30 second sit to stand. These scores were compared to age and gender established normative values. The physical function section of the Short Form 36 was chosen to provide a qualitative patient reported value. Therapists address impairments by prescribing exercise, adaptive equipment, compression garments or PT treatment. Results: The outcome tool scores of TTR patients were examined and compared to the same age and gender established normative data. Patients diagnosed with hereditary and wild-type TTR assessed in the CAC scored below same age and gender normative data on the TUG and 30 second sit to stand test indicating the need for physical therapy intervention to improve mobility, quality of life and reduce the risk of further decline. See Table 1. Conclusion: Patients with TTR amyloidosis present with physical impairments including reduced activity tolerance, strength and impaired balance as a result of disease side effects when compared to same age and gender normative data increasing their risk for falls and further decline. PT intervention is beneficial to improve the physical functioning, quality of life and reduce the risk of further decline. Future development of the PT assessment within the CAC will include specific cardiovascular and balance outcome tools.

T1

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Corresponding Author: Elyse Redder, PT, CLT-LANA
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