Hansen’s disease (also called Leprosy), a chronic granulomatous disease caused by an acid and alcohol fast bacillus Mycobacterium Leprae, mainly affects the peripheral nerves along with skin and mucous membrane. The peripheral nerves, affected mainly in multibacillary leprosy and during leprosy reactions, manifests as sensory loss (like anaesthetic foot), motor paralysis (like intrinsic minus hand, foot drop) and autonomic dysfunction (like dryness of skin) collectively called Hansens’s neuropathy and the resultant deformity in longstanding untreated patients. In addition to drug treatment, different types of physical medicine modalities like therapeutic exercises, orthosis, massage, electrical stimulation and modified shoe/slipper are usually advised for its management. Fifty patients of both sexes and different age groups attending outdoor of Physical Medicine and Rehabilitation (PMR) Department, Bankura Sammilani Medical College were selected for this prospective analytical study with the aim to evaluate the effect of these nonpharmacologic management. The results of the study showed that 79.3% and 61.5% of the affected nerves presented within 6 months of appearance of symptoms, recovered sensory and motor power satisfactorily. On the other hand, 57.6% and 6.6% of nerves affected in the disease process presented after 6 months of symptoms recovered their sensory and motor function satisfactorily. Excellent hand function and foot-ankle range of motion (ROM) were achieved by 60% of affected hands and 30% of foot-ankle affected by the disease who presented within 6 months of symptoms. However only 5.9% of hands and 12.5% of foot-ankle were achieved excellent functional score of the cases presented after 6 months of symptoms. These results indicate that nonpharmacologic therapies including physical therapy have a definite role in treating the patient of Hansen’s neuropathy in conjunction with drug therapy, different physical medicine therapies should be started as early possible for better improvement of nerve function and to prevent contracture, but established deformities cannot be corrected fully with these therapies.

Keywords: Hansen’s Disease, Leprosy, Neuropathy, Nonpharmacologic Treatment, Physical Therapies, Orthosis.

1. Agarwal S and Bhuptani N (2018). Clinico-histopathological Concordance in Leprosy patients- A study of 200 cases. Indian J Lepr. 90:147-153.
2. Moturu SR and Pamidipani SSR (2018). Inter-relationships among Delay,Defaulting,Deformity De-habilitation in Leprosy:Markars for Eradicating Leprosy in India. Indian J Lepr. 90:109-118.
3. do Nascimento MGB ,Lopes GL, Albuquerque NC at al(2018). The Relationship of Nerve Function Impairment and Symptoms in Leprosy. Indian J Lepr. 90: 101-108.
4. Croft RP, Richardus JH, Smith WCS (1997). Field Treatment of Acute Nerve Function Impairment in Leprosy Using a Standardised Corticosteroid Regimen-First Year’s Experience with 100 Patients. Lepr Rev. 68: 316-325.
5. Van Brakel WH and Khawas IB (1996). Nerve Function Impairment in Leprosy: an Epidemiological and Clinical Study-Part 2: Results of Steroid Treatment. Lepr Rev. 67: 104-118.
6. Smith WCS (1992).The Epidemiology of Disability in Leprosy Including Risk Factors. Lepr Rev. 63 Supplement:23S-30S.
7. Talwar S, Jha PK and Tiwari VD (1992). Neuritic Leprosy Epidemiology and Therapeutic Responsiveness.Lepr Rev. 63:263-268.
8. Minauchi Y and Igata A (1987). Leprous Neuritis in Hand Book of Clinical Neurology , Editor W. B. Matthews.Vol 7 (51):215-238.
9. Kiran KU, Stanley JNA, Pearson JMH(1985). The Outpatient Treatment of Nerve Damage in Patients with Borderline Leprosy using a Semi-standardised Steroid Regimen. Lepr Rev.56:123-134.
10. Srinivasan H, Rao KS, Shanmugam N (1982). Steroid Therapy in Recent Quiet Nerve Paralysis in Leprosy. LeprInd.54:412-419.

Dr Dilip Kumar Khatua

Professor, Dept. of P. M & R, B. S. Medical College & Hospital, Bankura