522 - Multidisciplinary Rehabilitation Management in a Patient with Stiff Person Syndrome: A Case Report

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

MS

Melissa Strike, DO, FAAPMR

Physiatrist
UCHealth (University of Colorado Health)
Colorado Springs, Colorado, United States

Corresponding Author(s)

JP

Joseph Powell, DPT

Supervisor Outpatient Rehabilitation
UCHealth (University of Colorado Health)
Colorado Springs, Colorado, United States
AS

April Strawn, CCC-SLP

Speech-Language Pathologist
UCHealth (University of Colorado Health)
Colorado Springs, Colorado, United States
CC

Corrin Criswell, OT

Occupational Therapist
UCHealth (University of Colorado Health)
Colorado Springs, Colorado, United States

Submitter(s)

MS

Melissa Strike, DO

University of Colorado Health System
Colorado Springs, Colorado, United States

Case Diagnosis: Stiff Person Syndrome

Case Description: NM is a 37-year-old man with anti-glutamic acid decarboxylase (GAD) antibody-positive SPS manifesting with severe axial stiffness, frequent falls, and poor balance. A multidisciplinary team was created by the leading Physiatrist comprising of Neurology, Rheumatology, Orthotics, Speech Language Therapy, Occupational Therapy and Physical Therapy. An individualized treatment plan consisted of immunotherapy with intravenous immunoglobulin (IVIG), symptomatic pharmacological management with muscle relaxers as well as Botulinum Toxin, and psychosocial therapy. Based on patient-specific goals, implemented interventions included task-specific gait training, implementation of spinal and knee orthoses, dry needling, cognitive-linguistic therapy, swallow exercises, postural training, and voice exercises.

Discussions: Stiff Person Syndrome (SPS) is a rare autoimmune condition characterized by the inhibition of gamma-aminobutyric acid (GABA) resulting in progressive rigidity, painful spasms and ambulatory dysfunction, all of which substantially increase the risk of falls and decrease quality of life. Although medications like muscles relaxers remain first-line for symptomatic management, these agents can exacerbate fall risk through increased sedation and cognitive side effects. Given these challenges, a multidisciplinary rehabilitation program is paramount in the treatment of SPS, although underreported in the literature. While there is no cure for SPS and spontaneous recovery is rare, early recognition and implementation of a comprehensive rehabilitation treatment plan is crucial to minimize disability and maximize function.

Conclusions:

Patient showed improvement in the Time Up and Go,10 Meter Walk Self-Selected, Five Times Sit to Stand, Neuro-Quality of Life cognitive-communication. Active shoulder flexion was not increased. Swallow function remained unchanged with no reports of aspiration pneumonia and no aspiration on MBSS. MOCA scores remained within functional limits and patient perception of voice on VHI-10 did not improve. This case supports a multidisciplinary rehabilitation in SPS to optimize function and independence in a disease known to result in functional decline. Further studies should explore standardized rehab protocols for SPS.