Exercise therapy for Catatonia Disorder

Catatonia Disorder treatment by exercise

Catatonia is generally considered to be a subtype of schizophrenia. However many other psychiatric (e.g. - bipolar mood disorders) as well a neurological illness (organic catatonia) can give rise to signs of catatonia.
Catatonia disorder is a group of symptoms characterized by disturbances in motor behavior that may have either a psychological or physiological basis. The best known of these symptoms is cerea flexibility which is rigid positioning of the body
held for a considerable length of time. Patients diagnosed with a catatonic disorder may maintain their body position for hours, days, weeks or even months at a time. Alternately, catatonic symptom away look like agitated purposeless movements that are seemingly unrelated to the person’s environment.
Catatonic patients require physiotherapy and exercise therapy as an adjunct to the medical treatment.
Since catatonia can be of various forms and intensity so its goals for treatment must also be patient oriented.
Some generalized goals for the treatments of catatonia can be:

• To increase the motivation in the patient.
• To increase balance
• To increase co-orientation
• To help patient not to develop pressure sores by advicing frequent change in position, using air mattress, keeping the body dry and clear.
• To make the patient independent in ADL’s (Activity of Daily Living).
• To start with the treatment of a completely bed-ridden patient the only position available for treatment would be lying position. In blying we can ask the patient to do active exercises of all joints, turning the patient to side lying.

Relaxations and deep breathing exercise will prove to be beneficial for the patient.

After lying, the patient is trained to sit with back support and progressed to sitting without back rest and high sitting position. In sitting to improvise patients ADL’s exercise with PNF (Proprioceptive Neuromuscular Facilitation) patterns can be a treatment of choice for both upper and lower extremities. To progress further catching and throwing activities can be added. From sitting when the patient is independent, he is trained to stand in a comfortable posture.

Weight shifting exercise and walking should be initially assisted followed by independent walking.

Last of all, the patient is asked to walk and work on standing one leg and kicking a ball etc. For improving balance and strength for the progression in ADL’s patient can be made independent from completely dependent position be assessing the patient on Barthel Index. In Barthel index the progression of the patient is graded form 0-10 in ADL’s like feeding, bathing, dressing, ambulation etc.

The role of physiotherapy in managing catato-nic and other motor symptoms is being recognized as a component of comprehensive managements of catatonic patient.

Source of Article: Jasvinder Kaur, Ayush Vashisht

Visit: Dr. A. Kalyan Chakravarthy, Psychiatry specialist.