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Collaborative Therapist-Patient Decision Making: A Power-Based Exercise Program for an Adolescent With CMT1A
James B Hedgecock1, Carolyn Kelley, Allison Jensen
1Department of Physical Therapy (Drs Hedgecock and Kelley), Rehabilitation Service Line, Children's Hospital Colorado, Aurora, Colorado; Doctor of Physical Therapy Program (Dr Rapport), College of Health and Society, Hawai'i Pacific University, Honolulu, Hawaii.
Purpose:
The purpose of this case report is to describe an episode of care for an adolescent with Charcot Marie Tooth disease (CMT) using a power-based progressive resistance exercise (PRE) and balance program to improve performance of participant-defined goals with added description through the voice of the patient as "participant lived experience."
Summary Of Key Points:
Participant discussion demonstrates improvement of functional performance for an adolescent with CMT subtype 1A (CMT1A), a progressive neuromuscular disorder. Function and participation-specific movement observation, clinical evaluation, and resistance training fostered appropriate program design and intervention dosing.
Conclusions And Recommendations For Clinical Practice:
A power-based progressive resistance exercise and balance program with design based on participant-defined goals was feasible, well tolerated, and successful for an adolescent with CMT1A. Inclusion of viewpoints of the "lived experience" provides deeper insight into patient perspective and clinical outcomes. Outcomes may improve when intervention is specifically dosed to participant goals and individual muscle performance requirements for targeted tasks.
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