# Long-Term Rehabilitation Therapy Is Effective for Physical Function in a Patient With Amyloid Light Chain Amyloidosis Complicated by Nephrotic Syndrome: A Case Report and Literature Review

## TL;DR

A patient with amyloid light chain amyloidosis and nephrotic syndrome showed physical improvements through long-term rehabilitation therapy.

## Contribution

Demonstrates the potential effectiveness of long-term physical therapy in patients with AL amyloidosis and nephrotic syndrome.

## Key findings

- Improvements in grip strength, lower extremity muscle strength, and phase angle after 24 weeks of therapy.
- Nephrotic syndrome showed a trend toward improvement despite persistent proteinuria.
- Home exercise therapy with compliance monitoring was feasible and beneficial.

## Abstract

We report on the rehabilitation of a patient with amyloid light chain (AL) amyloidosis complicated by nephrotic syndrome. Various symptoms produced by AL amyloidosis, including nephrotic syndrome, complicate rehabilitation therapy. In this case report, long-term physical therapy was initiated prior to autologous peripheral blood stem cell transplantation owing to the risk of further decline in physical function due to decreased mobility and physical activity. Patients were instructed on how to perform home exercise therapy. Furthermore, compliance was monitored using a checklist and regular face-to-face feedback. There was no increase in skeletal muscle mass, but improvements in grip strength, lower extremity muscle strength, and phase angle were observed after 24 weeks of physical therapy. Despite the absence of partial remission (urinary protein level of 3.5 g/gCre or higher), nephrotic syndrome demonstrated a trend toward improvement. Since the effectiveness of physical therapy in such patients has not yet been fully established, this report suggests that long-term rehabilitation therapy for physical function in patients with nephrotic syndrome complicated by persistent proteinuria may be effective.