Early Physiotherapy Intervention of a Patient with Acute Intermittent Porphyria-A Single Case Study


  • Jagruti K Patel
  • Nilima Patel




Acute intermittent porphyria, Barthel Index, Berge Balance Scale, Early physiotherapy intervention.


Background: The Porphyrias are metabolic disorders, each resulting from the deficiency of a specific enzyme
in the heme biosynthetic pathway. Acute intermittent porphyria (AIP) is an autosomal dominant inborn
error characterized by decreased activity of porphobilinogen (PBG) deaminase leading to increased levels
of haem precursors, namely amino levulinic acid (ALA) and PBG. The major manifestations of theacute
hepatic porphyrias are neurologic- neuropathic abdominal pain, peripheral motor neuropathy, and mental
disturbanceswith attacks often precipitated by steroid, hormones, certain drugs, and nutrition influences.
Purpose: Intensive care measures and a multidisciplinary therapeutic approach are essentialbut thereis less
documented evidence are available.If this aspect is incorporated early in the rehabilitation programme, then
the functional recovery in such will be better.so the aim of the study is to find how Early Physiotherapy
intervention using Comprehensive need based Approach to improve the functional status of porphyria
Key Points of Case: A 17 years old male patient wasdiagnosed with acute intermittent Porphyria. Having
the history of abdominal pain since last 3 months with family history of AIP which was diagnosed very late.
A detailed Physical and Neurological examination of this patient was taken. Along with medical treatment,
early physiotherapy intervention using comprehensive need base approach was being given to the patient.
The Barthel Index was taken to assess the functional status of the patient and Berg Balance Scale was taken
to assess balance on admission and subsequent follow-ups. Post-intervention follow-ups were taken at 6
weeks and 12 weeks period.
Conclusion: A clinically significant improvement was found on Barthel Index and Berg Balance Scale.
Early Physiotherapy intervention using a Comprehensive need based Approach is highly recommended to
improve the functional status of a patient with porphyria

Author Biographies

Jagruti K Patel

Assistant Professor, S.S. Agrawal Institute of Physiotherapy and Medical Care Education, Navsari

Nilima Patel

Ex I/C HOD & Principal College of Physiotherapy, S.S.G. Hospital, Vadodara Gujrat