Personalized adapted locomotor training for an individual with sequelae of West Nile virus infection: a mixed-method case report

ABSTRACT

Background

West Nile virus (WNV) can have severe consequences, including encephalitis and paralysis. Purpose: To describe the benefits of intensive locomotor training (LT) for an individual with a previous WNV infection resulting in chronic paraplegia. Case Description: The patient, who became a wheelchair user following standard rehabilitation, began LT 3 years post infection. Her goals included standing and walking with an assistive device and transferring independently. The intervention consisted of bodyweight-supported treadmill training and overground training, which involved walking, balancing, strengthening, and transferring activities. Outcomes: Following 5 months of LT, the patient ambulated independently with a walker at a speed = 0.34m/s. She walked 110.1 metres in 6 minutes and increased her Berg Balance Scale score by 17 points. These improvements were either maintained or further increased 3 months post LT. The patient’s perspectives on LT were collected through a semi-structured interview. A conventional content analysis, which uses data to drive themes, revealed three themes: (1) recalibrating goals, (2) outcomes (i.e. physical and psychological benefits, such as a sense of accomplishment), and (3) challenges of LT and effective coping strategies. Conclusions: The patient demonstrated improved balance and walking abilities. Intensive LT was feasible and effective for this individual with chronic paraplegia due to WNV infection.

KEYWORDS:

• West Nile virus
• locomotor training
• balance
• walking
• rehabilitation

Declaration of interest

The authors have no conflicts of interest to declare.

Additional information

Funding

This work was supported by the Ontario Neurotrauma Foundation [2013-SCI-RECOV2-974, 2016-RHI-PREV-1019].