1314 - Clinical Effectiveness of Comprehensive and Timely Rehabilitation: An 8-Year Case Report on Long-term Survival and Quality of Life Improvement in Corticobasal Degeneration

Case Diagnosis: Atypical Parkinsonism; Corticobasal Degeneration (CBD)

Case Description: A 72-year-old female presented with postural instability, limb rigidity, and bradykinesia, leading to a diagnosis of CBD. Prior to COVID-19, she regularly attended physical therapy (PT) and occupational therapy (OT), which helped maintain her physical and mental abilities. However, at age 78, following a COVID-19 infection, she experienced a rapid decline, developing dysphagia and losing expressive abilities, eventually becoming bedridden. Subsequent treatment focused on preventing complications common in advanced CBD while supporting rehabilitation and emotional well-being. During seven hospitalizations following the COVID-19 diagnosis, care included treating aspiration pneumonia, active cardiopulmonary monitoring, and the insertion of a percutaneous endoscopic gastrostomy (PEG) tube and a peripherally inserted central catheter (PICC). She continued comprehensive PT and OT. Home care emphasized emotional support and managing depression by maximizing family time, with the caregiver trained to ensure continuous complication management.

Discussions: This patient exhibited advanced CBD symptoms, including apraxia, dysphagia, limb dystonia, and depression. Despite the typically poor prognosis of CBD, with an average survival of 6.5 years post-onset, she has survived over 8.25 years since onset in June 2016, aided by a comprehensive rehabilitation strategy involving both hospital and outpatient care. This case demonstrates that a person-centered approach can optimize quality of life by:

• Proactive Complication Prevention: Prompt PEG insertion to ensure stable nutritional support, dysphagia rehabilitation, and cardiopulmonary rehabilitation to prevent heart failure and pneumonia.


• Timely PT and OT: These helped maximize independence, reflected in stable scores on MBI, MFT, and CDR. Despite reduced mobility post-COVID-19, continued rehabilitation prevented contractures.


• Stable Home Care: The caregiver was trained in PEG tube care, respiratory secretion management, and pressure ulcer prevention.

Conclusions: A comprehensive, patient-centered approach with timely rehabilitation and complication prevention can extend survival and enhance quality of life, as demonstrated by the patient's ongoing survival of 8.25 years.