Taishi Kikkawa, RPT, MS, Akemi Takashima, MD
Jpn J Compr Rehabil Sci 14: 49-53, 2023
Introduction: Acute motor axonal neuropathy
(AMAN) requires aggressive gait rehabilitation from
the early phase of its onset due to the long time
required to achieve independent gait. In this report, we
describe the progress of gait training using a
combination of lower-limb orthosis and body weightsupported
(BWS) walker in a patient with severe
AMAN.
Case: A 30-year-olds man diagnosed with AMAN
underwent two high-dose intravenous immunoglobulin
treatments and combined steroid pulse therapy. The
patient was admitted to the convalescent rehabilitation
ward for 87 days with a Medical Research Council
(MRC) score of 7 points for muscle strength and 13
points for Functional Independence Measure (FIM)
motor items. He started gait training with a kneeankle-
foot orthosis on the 128th day. Thereafter, the
distance of gait training increased with the use of
lower-limb orthosis and BWS walker. At the time of
discharge, the patient's MRC score had improved to
24 points and his FIM motor items score to 31 points.
He was able to walk 90 m using ankle-foot orthosis
and forearm walker and was transferred to a
rehabilitation facility on day 237.
Discussion: Gait training with lower-limb orthosis
and BWS walker was performed on a patient with
severe AMAN. As a result, gait training distance
increased without adverse events. Gait training can be
performed safely and effectively by combining lowerlimb
orthosis and BWS walker when gait ability is
expected to improve, even in severely ill patients.
Key words: acute motor axonal neuropathy, kneeankle- foot orthosis, ankle-foot orthosis, body weightsupported overground training