Beyond the CIDP Infusion: Why Physical Therapy Is Your Secret Weapon for Remission

Below, learn why physical therapy for CIDP is so vital.

“Neurological physical therapy does not treat the immune cause of CIDP (that is managed medically), but it can play an important role in optimizing nerve signaling, preserving one’s function, and helping to prevent secondary complications arising from the condition,” says Joseph Hribick, DPT, a physical therapist and a clinical assistant professor of physical therapy at Lebanon Valley College in Annville, Pennsylvania.

Re-mapping doesn’t mean growing new nerves overnight, says Hribick. “It means teaching the nervous system to use the signals it does have more efficiently through repeated, meaningful movement.”

Specialized and Supervised Recovery

“The goal of physical therapy for individuals with CIDP is to promote improvements in muscular strength, endurance, and balance to improve their daily functioning while decreasing fatigue and pain levels,” says Dr. Mikos.

“As a neuromuscular physician I trust our neurologically trained physical therapists to create a patient specific plan tailored to their underlying diagnosis, current physical challenges, and goals,” says Rebecca Hurst, MD, the chief of neurology at Tampa General Hospital and associate professor of neurology at University of South Florida Morsani College of Medicine.

Improving Balance and Preventing Falls

After a thorough evaluation, your neurologic physical therapist will design a comprehensive exercise and functional training program to address your specific needs, interests, and goals, says Mikos, adding that therapies may include:

• Low to moderate intensity strength training to address muscular weakness
• Flexibility and stretching to address areas of limited range of motion
• Balance training to promote improved stability when standing and walking
• Task-specific mobility training such as getting in and out of a chair, going up and down ‌stairs, or getting onto and off‌ the floor

Fine Motor Skills and the Role of Occupational Therapy

• Squeezing a ball
• Making a fist, then spreading your fingers wide
• Placing your hands palms down on a surface and lifting each finger

Neurologic physical therapy for CIDP can individualize your exercise “blueprint” based on the severity of the disease, your fatigue tolerance, and how much sensory loss you have, says Hribick.

• Aquatic therapy (exercising in a pool)
• Recumbent cycling
• Isometric strengthening (tightening muscles without moving your joints)

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• Low-impact aerobics class

As you prepare to choose a physical therapist, look for one who has background and training in neurologic disorders — they will better understand how to target therapy for CIDP, says Dr. Hurst.

If you’re not sure you’ve found the right PT for your needs, Hribick recommends asking candidates these questions:

• Do you have experience treating demyelinating neuropathies?
• How do you manage fatigue and symptom fluctuations?
• Will you coordinate with my neurology and infusion teams?

“You can find a board certified neurologic clinical specialist in your area by using the American Physical Therapy Association’s PT Directory online,” says Mikos.

Another way to vet your PT is to look for “Neurologic Clinical Specialist (NCS)” credentials or documentation that your therapist regularly works with people with neurological conditions such as peripheral neuropathies, multiple sclerosis, or Guillain-Barré disorders, says Hribick.

• 10-Meter Walk Test measures walking speed
• Six-Minute Walk Test measures how far you can walk in six minutes

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• Timed Up and Go (TUG) Test measures how long it takes to stand up from sitting in a chair with armrests, walk three meters (9.8 feet), walk back to the chair and sit down
• 30-Second Chair Stand measures how many times you can stand up from and sit down in a chair with your arms crossed across your chest in 30 seconds

• Medical treatments for CIDP can ease symptoms, but physical therapy provides vital muscle strengthening for better and faster recovery.
• A neurologic physical therapist who specializes in treating muscle weakness from nerve conditions can help you improve your balance, fine motor skills, and endurance.
• To find a neurologic physical therapist near you, you can search on the American Physical Therapy Association’s PT Directory online or ask your provider for a recommendation.