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General Rehabilitation

A POEMS of Progress: Multidisciplinary Rehabilitation in a Rare Multisystem Disease

Saturday, October 25, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 1

    Poster Presenter(s)

  • Emad Sidiqi

    Medical Student
    Kansas City University of Medicine & Biosciences College of Osteopathic Medicine
    Kansas City, Missouri

  • MD

    Miguel DeMarzo, DO, MPH

    Resident
    Baylor Scott & White All Saints Medical Center
    Arlington, Texas

    • Co-Author(s)

  • CK

    Clifford Kissling, MD

    Medical Director
    Wesley Rehabilitation Center
    Maize, Kansas

Disclosure(s):
Emad Sidiqi: No financial relationships to disclose
Case Diagnosis: Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome with severe deconditioning and respiratory failure requiring prolonged hospitalization and rehabilitation.

Case Description or Program Description: A 56-year-old male with POEMS syndrome presented with acute respiratory failure secondary to MRSA and ESBL E. coli pneumonia, requiring two intubations and an extended ICU stay. His hospitalization was complicated by sepsis, adrenal insufficiency, atrial fibrillation with RVR, pleural effusion, ascites, and ileus. Prior to hospitalization, he was independent with wheelchair mobility, required varying levels of assistance for ADLs, and could ambulate ~50 ft with a walker. Severe muscle wasting left him fully dependent for mobility and self-care, necessitating inpatient rehabilitation.

Setting: Inpatient rehabilitation unit (IRU) following ICU and long-term acute care hospital (LTACH) stay.

Assessment/Results: On admission, the patient was profoundly weak and required maximal assistance for transfers and ADLs. Rehabilitation was complicated by severe fatigue, autonomic instability, and poor endurance. His program included progressive resistance training, neuromuscular re-education, and functional mobility exercises focusing on balance, transfers, and gait training with a front-wheeled walker. Goals were achieved through interdisciplinary efforts including PT/OT/ST. Family training addressed transfer safety and ADL assistance to facilitate a safe transition home. Upon discharge, he achieved independent wheelchair mobility and partial/moderate assistance for bed transfers (1 → 3), lower body dressing (1 → 2), and showering (2 → 3). Functional gains highlighted efficacy of rehabilitation in POEMS-associated deconditioning.

Discussion (relevance): POEMS syndrome presents unique rehabilitation challenges due to severe polyneuropathy and systemic involvement. Prolonged hospitalization worsened deconditioning, further complicating rehabilitation. Limited literature exists on rehabilitation in POEMS, making case-based evidence valuable. Multidisciplinary interventions optimized recovery by addressing fatigue, autonomic instability, and endurance limitations.

Conclusions: Intensive inpatient rehabilitation facilitated meaningful recovery in a patient with POEMS syndrome and critical illness myopathy. Early, structured rehabilitation and family training were key in optimizing independence and ensuring a safe discharge home.