Charcot-Marie-Tooth disease...

[ipekbensuxoxo]

Anyone have any info on this? I have a new client coming in this week with it and am looking for insight.

 

[Miss G]

Charcot-Marie-Tooth disease...

First, here's a good start for learning more about this condition: http://www.ninds.nih.gov/disorders/charcot_marie_tooth/detail_charcot_marie_tooth.htm

I suggest you find out exactly which version your client has, so you can better understand their particular situation.

This section is particularly relevant for you:

How is Charcot-Marie-Tooth disease treated?
There is no cure for CMT, but physical therapy, occupational therapy, braces and other orthopedic devices, and even orthopedic surgery can help patients cope with the disabling symptoms of the disease. In addition, pain-killing drugs can be prescribed for patients who have severe pain.

Physical and occupational therapy, the preferred treatment for CMT, involves muscle strength training, muscle and ligament stretching, stamina training, and moderate aerobic exercise. Most therapists recommend a specialized treatment program designed with the approval of the patient's physician to fit individual abilities and needs. Therapists also suggest entering into a treatment program early; muscle strengthening may delay or reduce muscle atrophy, so strength training is most useful if it begins before nerve degeneration and muscle weakness progress to the point of disability.

Stretching may prevent or reduce joint deformities that result from uneven muscle pull on bones. Exercises to help build stamina or increase endurance will help prevent the fatigue that results from performing everyday activities that require strength and mobility. Moderate aerobic activity can help to maintain cardiovascular fitness and overall health. Most therapists recommend low-impact or no-impact exercises, such as biking or swimming, rather than activities such as walking or jogging, which may put stress on fragile muscles and joints.

Many CMT patients require ankle braces and other orthopedic devices to maintain everyday mobility and prevent injury. Ankle braces can help prevent ankle sprains by providing support and stability during activities such as walking or climbing stairs. High-top shoes or boots can also give the patient support for weak ankles. Thumb splints can help with hand weakness and loss of fine motor skills. Assistive devices should be used before disability sets in because the devices may prevent muscle strain and reduce muscle weakening. Some CMT patients may decide to have orthopedic surgery to reverse foot and joint deformities.

Here's another good page to explore: http://www.charcot-marie-tooth.org/experts.php?fcid=9#2
And here's a relevant segment of that page:

2. I am a student of massage therapy and I have a friend who has CMT. She is 21 and all the women in her family have the disorder. Some of the symptoms I've read about are treatable with massage therapy. Are there any contraindications? Is there a type of massage therapy that should not be practiced on someone with CMT? Can massage therapy prevent the need for surgery?

Massage is often appropriate for people with neuromuscular disease. Because of frequent muscle strength imbalances, with some muscles becoming shortened and some becoming overstretched, massage can assist in maintaining muscle tissue mobility and thus aid in decreasing pain. I am not sure it could help prevent the need for surgery, unless only minor muscle restrictions are the problem.

As to contraindications, the most important is that people with CMT have sensory loss and abnormalities. A sensory exam should, therefore, precede any vigorous massage session or the use of heat/cold therapy.

If you are not familiar with sensory exams, consider referring this client elsewhere.

Here is an excerpt from Mosby's Pathology for Massage Therapists - Read the entire section on Peripheral Neuropathy, and pay extra attention to the "Massage Considerations" - You need to exercise appropriate caution and be willing to refer out even if the client would prefer to see you. This is NOT a condition to mess around with; you can cause harm without immediately knowing it.
Excerpt link: http://books.google.com/books?id=uz_FAjP6HzMC&pg=PA190&lpg=PA190&dq=charcot-marie-tooth+disease+massage&source=bl&ots=S3s3JdileB&sig=o3F03H7cf1tuU58acBZAk7PymFg&hl=en&ei=kRO9TMXvD6O0nAfEy_GJDg&sa=X&oi=book_result&ct=result&resnum=3&ved=0CBoQ6AEwAjgK#v=onepage&q=charcot-marie-tooth%20disease%20massage&f=false

 

[hockeyking_21]

Charcot-Marie-Tooth disease...

Thanks Jason! I did some research last night but all the info I can gain is a help. I don't know which version she has, I definitely check that out.

Anyone have any experience working with this disease?