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Peripheral neuropathies make up a group of disorders that affect the nerves outside the brain and spinal cord. These disorders may affect the nerves that help stimulate movement (motor nerves), feel different things (sensory nerves) or both. One type of hereditary peripheral neuropathy is Charcot-Marie-Tooth (CMT) disease. (CMT is named after the three physicians who first described it in 1886: Jean-Martin Charcot, Pierre Marie and Howard Henry Tooth.)
In CMT, the motor nerves are most severely affected. Symptoms of CMT include progressive distal muscle weakness of the legs and hands, changes in the position of the foot, altered sensation which impairs functional movement patterns, and decreased circulation in the feet and hands.
Children with CMT may have difficulty with walking and navigating stairs, decreased endurance, trouble fastening buttons, writing or sustaining a grip on objects. Occupational and physical therapy are helpful in providing individuals with strengthening activities, movement strategies and assistive devices to help with energy maximization. While it is not possible to build up muscles that are already atrophied by CMT, therapy will focus on strengthening muscles that are unaffected so that they can do the work of the muscles that are unable to function.
The changes in the position and strength of the feet and hands may lead to a need for splints or braces in order to help maintain optimal positioning and functioning of the body part over time. Physical therapy and occupational therapy work collaboratively with orthotics to help determine the optimal devices to help improve function. Together, these interventions can help children to maximize independence and participation in all environments.
Watch the video below to see an occupational therapy session with a child with Charcot-Marie-Tooth disease.