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Pudwell, Heather

University of British Columbia

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated peripheral polyneuropathy leading to progressive demyelination of (primarily) spinal nerve roots, proximal nerve trunks, and major nerve plexuses. Symptoms include a progressive loss of strength, sensation, and reflex responses. CIDP is unique in that deficits are seen both proximally and distally. A common treatment for CIDP, intravenous immunoglobulins (IVIg), has been effective in slowing the demyelination process and allowing for remyelination to occur. Patients with CIDP often report issues with balance as a main concern. Most balance research in CIDP has only used static and/or subjective clinical measures. Dynamic posturography has been used in other patient groups, but has yet to be used in a proximal/distal combined polyneuropathy like CIDP. Therefore, this thesis had two goals: (1) characterize balance (static and dynamic) in CIDP, and (2) determine if/how treatment affects balance in CIDP. Data from 13 CIDP patients and 13 healthy controls was used in analyses. Participants completed two testing sessions, approximately 4 weeks apart (patients completed one visit with IVIg at its peak effect and one when its effects were wearing off). During each session, participants completed strength/sensory assessments, clinical balance tests, static balance tasks, modified stance and gait tasks, and a series of perturbations on a multi-directional tilting platform. Consistent with previous work, results showed differences between the CIDP and HC groups across clinical, static, and modified stance and gait tasks. This was the first study to investigate muscle responses to unexpected support surface perturbations in CIDP, and there was evidence for delayed and reduced responses across multiple perturbation directions. Additionally, CIDP patients showed improved performance across static, modified stance and gait, and dynamic tasks with medication. This is the first study to demonstrate such differences with medication using dynamic posturography in CIDP.

Text

2024-03-07

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/87532

Kinesiology

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/