Physiotherapy Approach for Susac Syndrome

Susac Syndrome Clinical Trial

Official title:

Integrated Physiotherapy Approach for Susac Syndrome: A Comprehensive Case Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT06349603
• Other study ID #: S2023
• Status: Completed
• Start date: February 13, 2023
• Est. completion date: April 6, 2023

Study information

• Verified date: April 2024
• Source: Rehabilitation Centre Zivot
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Susac's syndrome is a rare autoimmune disorder characterised by a triad of encephalopathy (brain dysfunction), branch retinal artery occlusion (loss of vision) and sensorineural hearing loss. This study presents the case of a patient undergoing intensive physiotherapy intervention following an injury, focusing on assessments such as volume and range of motion measurements, manual muscle tests, and pain intensity evaluations using various scales.

Description:

The patient, aged 17, initially presented with severe limitations in mobility, diagnosed with Susac syndrome. Requiring assistance to walk even short distances due to fear and insecurity. Through a structured physiotherapy program spanning several months, various assessments were conducted, including manual muscle tests and circumference measurements. Significant improvements were observed for muscle function, upper and lower limb circumferences, and performance in mobility tests.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1
• Est. completion date: April 6, 2023
• Est. primary completion date: April 1, 2023
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Confirmed diagnosis of Susac syndrome.
• Willingness and ability to participate in a 12-week intensive physiotherapy program.
• Stable medical condition that allows participation in physiotherapy without significant risks.
• Ability to provide informed consent for participation in the study.

Exclusion Criteria:

• Presence of severe comorbidities or medical conditions that would interfere with participation in physiotherapy or confound the study outcomes.
• Inability to comprehend or follow the instructions for physiotherapy exercises.
• Pregnancy, as certain physiotherapy modalities may not be suitable during pregnancy.
• Any other condition or circumstance that, in the opinion of the investigator, would compromise the safety or validity of participation in the study.

Related Conditions & MeSH terms

• Susac Syndrome
• Syndrome

Locations

Country	Name	City	State
Bosnia and Herzegovina	Rehabilitation centre Život	Mostar

Sponsors (1)

Lead Sponsor	Collaborator
Rehabilitation Centre Zivot

Country where clinical trial is conducted

Bosnia and Herzegovina, 

References & Publications (14)

Ahmad A, Tariq F, Zaheer M. Incomplete Susac's Syndrome: A Case Report and Literature Review. Cureus. 2022 Aug 11;14(8):e27903. doi: 10.7759/cureus.27903. eCollection 2022 Aug. — View Citation

Bose S, Papathanasiou A, Karkhanis S, Appleton JP, King D, Batra R, Mollan SP, Jacob S. Susac syndrome: neurological update (clinical features, long-term observational follow-up and management of sixteen patients). J Neurol. 2023 Dec;270(12):6193-6206. doi: 10.1007/s00415-023-11891-z. Epub 2023 Aug 22. — View Citation

Coulette S, Lecler A, Saragoussi E, Zuber K, Savatovsky J, Deschamps R, Gout O, Sabben C, Aboab J, Affortit A, Charbonneau F, Obadia M. Diagnosis and Prediction of Relapses in Susac Syndrome: A New Use for MR Postcontrast FLAIR Leptomeningeal Enhancement. AJNR Am J Neuroradiol. 2019 Jul;40(7):1184-1190. doi: 10.3174/ajnr.A6103. Epub 2019 Jun 27. — View Citation

Cvikova M, Stefela J, Vsiansky V, Dufek M, Dolezalova I, Vinklarek J, Herzig R, Zemanova M, Cervenak V, Brichta J, Barkova V, Kouril D, Aulicky P, Filip P, Weiss V. Case report: Susac syndrome-two ends of the spectrum, single center case reports and review of the literature. Front Neurol. 2024 Feb 16;15:1339438. doi: 10.3389/fneur.2024.1339438. eCollection 2024. — View Citation

David C, Sacre K, Henri-Feugeas MC, Klein I, Doan S, Cohen FA, Jouvent E, Papo T. Susac syndrome: A scoping review. Autoimmun Rev. 2022 Jun;21(6):103097. doi: 10.1016/j.autrev.2022.103097. Epub 2022 Apr 10. — View Citation

Egan RA. Diagnostic Criteria and Treatment Algorithm for Susac Syndrome. J Neuroophthalmol. 2019 Mar;39(1):60-67. doi: 10.1097/WNO.0000000000000677. — View Citation

Luan X, Tian X, Zhang H, Huang R, Li N, Chen P, Wang R. Exercise as a prescription for patients with various diseases. J Sport Health Sci. 2019 Sep;8(5):422-441. doi: 10.1016/j.jshs.2019.04.002. Epub 2019 Apr 18. — View Citation

Masjuan M, Ivanovski T, Sarasibar Ezcurra H, Rigo Oliver E. Behavioral Impairment and Amnesia at the Onset of Susac Syndrome. Cureus. 2023 Apr 25;15(4):e38089. doi: 10.7759/cureus.38089. eCollection 2023 Apr. — View Citation

Patil S, Gs V, Sarode GS, Sarode SC, Khurayzi TA, Mohamed Beshir SE, Gadbail AR, Gondivkar S. Exploring the role of immunotherapeutic drugs in autoimmune diseases: A comprehensive review. J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):291-296. doi: 10.1016/j.jobcr.2021.02.009. Epub 2021 Feb 23. — View Citation

Pereira S, Vieira B, Maio T, Moreira J, Sampaio F. Susac's Syndrome: An Updated Review. Neuroophthalmology. 2020 May 1;44(6):355-360. doi: 10.1080/01658107.2020.1748062. eCollection 2020. — View Citation

Reedy MB, Wang Y, Beinlich BR, Rose WN. Successful Treatment of Incomplete Susac Syndrome with Simultaneous Corticosteroids and Plasmapheresis Followed by Rituximab. Case Rep Neurol Med. 2021 Aug 12;2021:5591559. doi: 10.1155/2021/5591559. eCollection 2021. — View Citation

Rennebohm RM, Asdaghi N, Srivastava S, Gertner E. Guidelines for treatment of Susac syndrome - An update. Int J Stroke. 2020 Jul;15(5):484-494. doi: 10.1177/1747493017751737. Epub 2018 Jan 10. — View Citation

Sveinsson O, Kolloch J, Traisk F, Brundin L. [Susac syndrome - an unusual syndrome which can be mistaken for multiple sclerosis]. Lakartidningen. 2020 Feb 10;117:FSSS. Swedish. — View Citation

Wilf-Yarkoni A, Elkayam O, Aizenstein O, Oron Y, Furer V, Zur D, Goldstein M, Barequet D, Hallevi H, Karni A, Habot-Wilner Z, Regev K. Increased incidence of Susac syndrome: a case series study. BMC Neurol. 2020 Sep 2;20(1):332. doi: 10.1186/s12883-020-01892-0. — View Citation

* Note: There are 14 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Mobility and Muscle Strength Improvement	This outcome measure evaluates improvements in mobility in a single individual with Susac syndrome following 12 weeks of intensive physiotherapy. Assessments include the Timed Up and Go test (TUG), which measures the time taken for the individual to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down. Progress is indicated by the transition from heavy reliance on assistance for mobility to independent walking for 100 meters.	Assessed at baseline and after 12 weeks of intensive therapy.
Primary	Muscle Strength Improvement Outcome Measure	This outcome measure evaluates improvements in muscle strength in a single individual with Susac syndrome following 12 weeks of intensive physiotherapy. Assessments include manual muscle tests (MMT) to assess the strength and function of specific muscle groups, using a standardized grading scale. Progress is indicated by higher grades in manual muscle tests, reflecting improved muscle strength and endurance.	Assessed at baseline and after 12 weeks of intensive therapy.
Primary	Pain Intensity Outcome Measure	This outcome measure evaluates changes in pain intensity experienced by the individual with Susac syndrome following 12 weeks of intensive physiotherapy. Pain intensity is assessed using the Visual Analog Scale (VAS), where the individual rates their pain on a scale from 0 to 10, with 0 indicating no pain and 10 indicating the worst possible pain. Progress is indicated by a decrease in VAS scores, reflecting reduced pain intensity.	Assessed at baseline and after 12 weeks of intensive therapy.

External Links

•   A case of possible Susac syndrome with avascular necrosis of hip
•   Physiopedia contributors. (2022). Timed Up and Go Test (TUG). Physiopedia.
•   Physiopedia contributors. (2023). Benefits of Rehabilitation. Physiopedia.
•   Physiopedia contributors. (2024a). Assessing Range of Motion. Physiopedia.
•   Physiopedia contributors. (2024b). Muscle Strength Testing. Physiopedia
•   Susac syndrome
•   Susac Syndrome: Collaboration is Required for a Diagnosis