Appendix 2 - evaluation of neurological condition of 10 cases after five-days’ clavitherapeutic treatment

From: Matylda Strzelecka-Górzynska, M. D., Diplomate in Neurology, Piastów, 14134 Tysi1clecia St, Poland

In April and May of 1999 nine patients with disseminated sclerosis were examined, each case having been formerly confirmed by means of hospital observation and NMR. The patients were able to produce any necessary medical documentation such as hospital forms and NMR files. There occured one case of amyotrophic lateral sclerosis (ALS), a motor neuron disease, with eight months' history of illness. Nine patients out of that ten completed the training, one person called off due to some conflicts among the trainees. The group consisted of 4 females (age 38 up to 46) and 6 males 9 (age 38 up to 51), Case histories spanned periods of time ranging from five to eleven years. Nobody had been subject to steroid therapy for at least three months, nor was experiencing such medication at that moment. Cases were classified into three subtitles: the first one of slow DS (SM) progress (2), the second of progressive process with aggravations (4), the third of intermittent crisis type (3). For the last three months no significant progress or crisis had been reported in that group. One patient with ALS was obviously showing some deterioration and was in the middle of RILUTEK once-a-day treatment. The following neurological findings were reported on admission:

· two females revealed spastic paresis of lower limbs and cerebellar syndrome

· two other females showed dominating spastic hemiparesis, superficial sensation deficiency and numbness.

. four men were suffering mainly from lower limbs spastic paresis

· one male patient was complainig of hemianaesthesia with cerebellar syndrome · the only patient with ALS developed spastic paresis of lower limbs and atonic paralysis of right upper limb, shoulder muscle atrophy, with no sensation disorders.

All persons invited to the program were very cooperative and eager to take part in the therapy, even for prolonged routine. Much trust and hope was shown up as a chance to get better appeared. Final inspection revealed as follows:

· one person gave up for personal reasons

· one person was hardly able to admit any improvement and claimed little effect. Physical examination pointed to a slight decrease in lower limb spasticity thus upgrading motoric abilities.

· the others' reports were far more optimistic as their paretic limbs gained some more extent of movements and longer distances of self-dependent walk. Numbness and formication as sensational vexatious experiences were also significantly withdrawn. Two patients appreciated better sphincter control. Objective findings confirmed decreased spasticity in paretic limbs with all consecutive advantages as movement extension and accuracy together with somatic improvement.

· there were also some additional comments of improved eyesight and sensory disorder relief, but no objective clinical tests were applied to verify them, such as evoked sensory potentials or ophtalmologic assessment.

Formerly evident pyramidal deficiencies were still present, to mention paradoxical extensor reflex, plantar muscle reflex and asymmetric reflexes. Cerebellar symptoms of nystagmus and dysmetria together with cranial nerve lesions producing strabismus - all those findings persisted without changes.

Distant results of therapy were not verified and only five days' watch was performed.

CONCLUSIONS:

Eight cases of disseminated sclerosis and one of amyothropic lateral sclerosis were subject to preliminary and consequent examination. The final conclusions that could be drawn after five days' course seem to appreciate clavitherapy as an auxiliary tool in neurological rehabilitation. The main positive effect was that of reducing spasticity of paretic limbs as well as defeating patients' reluctance to take up exercise. Patient being cooperative and optimistic, far better results can thus be achieved and motoric abilities may upgrade.

The physician in charge of trial assessment was not involved in therapy in any way, therefore remained objective.

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Appendix 3