MANAGING SYMPTOMS( continued)
For Walking
• Gait training with a focus on preventing small steps, having adequate foot clearance and heel strike, and not moving too quickly.
• Safe turning techniques, such as making U-turns in open spaces, avoiding pivot turns, and avoiding crossing one foot over the other.
For Antecollis( A Neck That Has Tilted Forward)
• Stretching and positioning / bracing
• A tilt wheelchair or recliner
• Botox is not often used because of the possibility of causing further speech and swallow problems
For Dolls’ Eye Movement( Eyes Moving in Opposite Direction of Head Turn)
• Stop before turning. Turn head in direction of turn. Work to bring the gaze in direction of turn. Perform turn.
• Early on in the disease, tilting the head down may help with bringing the gaze down. Eventually, this will not be the case.
To Prevent Backward Falls
50
• Avoid bending or reaching low and standing up quickly.
• To open doors, cabinets, refrigerator, etc., stand sideways in a wide, staggered stance with one hand on a steady surface.
Physical Therapy Strategies and Recommendations for Corticobasal Degeneration( CBD)
Recommendations That Patient and Carepartner Consult with Physician Regarding
• Dystonia: botulinum toxin, stretching, positioning / bracing
• Aerobic, therapeutic, and balance exercises along with fall prevention training
• Use and exercise of affected limb
• Stretching, positioning, and bracing to prevent contractures
• Gait training based on needs
• Appropriate assistive devices for walking( may not be able to use because of“ alien limb,” apraxia, or contractures; may need physical assistance or wheelchair instead)
• Safe turning techniques: – Make U-turns in open spaces. – Avoid pivot turns. – Avoid crossing one foot over the other.