Arrow ImageAcute, PICU and Rapid Response

Posted on Mar 2 2023 by Fiona Bailey

A patient who was admitted to St Andrew’s Healthcare in a catatonic state – which meant she could not talk or move - has been discharged from hospital having gained full communication and mobility.

On admission Rose was bed-bound, mute, immobile and unable to feed. With a longstanding history of schizophrenia and mood disorders, her condition had significantly worsened.

Specialist physiotherapist Jyothi Kraleti, who supported Rose throughout her recovery, said: “She couldn't talk to us, and was only able to make the same expression - for fear, for pain and for anything positive. It was very difficult to reassure her and provide the right care.

By using a multi-disciplinary approach, led by the physiotherapy team, Rose was supported in her recovery in a case so unique that Jyothi has now written a paper as a reference point for other clinical teams. An article about work has been published in the NR Times.

Rose’s schizoaffective catatonia resulted in an inability to use her arms or legs, or to speak. While the condition is very rare, each manifestation is different - meaning Rose’s case was unique and unlike anything the St Andrew’s multi-disciplinary team had seen before.

Physiotherapy proved particularly important in Rose’s rehabilitation, with a bespoke regime to initially free her from her catatonic stupor, gaining in momentum as she regained her ability to move.

Working alongside psychologists and supported by a combination of medication and treatment - which was continually adjusted until it could best support Rose’s recovery - the physiotherapy team were able to lead Rose’s rehabilitation during her time with St Andrew’s.

Having secured such a successful outcome for Rose and her family during the five-month programme, Jyothi’s case study paper has been written to help guide and inform other therapeutic teams about the unique circumstances of this patient, the interventions and engagement from the St Andrew’s team and lessons learned along the way.

While the majority of previous studies have primarily used drug therapy, this case involved a multidisciplinary approach, with physiotherapy playing a key role in Rose’s recovery. 

Jyothi said: “Rose’s diagnosis was very complex, and in these cases each particular patient comes with a different presentation.

“We referred to Journals but the approaches identified were deemed unsuitable for our patient, even though it was the same diagnosis.

“However, drawing the skills from across our specialist multi-disciplinary team meant that we were able to help Rose secure a very positive outcome. Her family were incredibly happy. I think the combination of the right interventions with the right frequency was very important here, and without our MDT working, I’m not sure we’d have got that.

“This is a very unique situation and that is why we wanted to produce a paper.

“I wanted to shine some light on this case so that other physiotherapy teams and  psychiatrists can think ‘Oh, I have this patient, is  there any reference to a similar case that can help us to define a clinical approach?’”

To read Jyothi’s NR piece, click here.