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Early Intervention as an Agent for Recovery of Function After Spinal Cord Injury- A Single Case Study

Received: 22 April 2018     Accepted: 21 May 2018     Published: 9 July 2018
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Abstract

This case study describes a task-specific training program for working and functional recovery in a young man with incomplete cervical spinal cord injury. The subject was 20 year old male with traumatic spinal cord injury after a fall from height. Prior to intervention, he was quadriplegic with severe motor and sensory impairment. Our goal was to recover the function. The subject underwent disectomy for anterolisthesis of C6 over C7. Acute spinal cord management was started followed by locomotor training, electrical stimulation, orthoses, specialised assistive devices. Outcome measures used were ASIA scale, walking index for SCI, SCIM, Fatigue severity scale, Beck depression scale, SCI-FAI. It was found that specific interventions were intentionally selected in the development of treatment program which helped in the functional recovery of the patient. After 3 and half months treatment, the subject was able to walk with the assistance of AFOs and walker, and was able to perform ADLs independently. The magnitude of his functional improvements could be attributed to early intervention and neuroplasticity.

Published in International Journal of Neurologic Physical Therapy (Volume 4, Issue 2)
DOI 10.11648/j.ijnpt.20180402.12
Page(s) 34-39
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Rehabilitation, Spinal Cord Injury, Quadriplegia, Task Specific Intervention

References
[1] Somers MF: Spinal Cord Injury Functional Rehabilitation, 3rd Ed. Prentice Hall; 2001
[2] O’Sullivan SB, Schmitz TJ. Traumatic spinal cord injury in Physical Rehabilitation, F. A. Davis, Philadelphia. 6th ed, 2014:889-963.
[3] Rahimi-Movaghar V et al. Epidemiology of traumatic SCI in developing countries: A systemic review, Neuroepidemiology 2013 Jun; 41(2): 65-85.
[4] Maheshwari and Mhaskar: Essential Orthopaedics (including clinical methods), Jaypee Publications. 5th ed, 2015:267.
[5] Dolbow DR, Gorgey AS, McDonald JW: Activity based restorative therapies after spinal cord injuries: Interinstitutional conceptions and perceptions, Ageing Dis. 2015 Aug; 6(4): 254-261.
[6] Steven C. Kirshblum, Stephen P. Burns, Fin Biering-Sorensen, William Donovan, Daniel D. Graves, Amitabh Jha, et al: International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med. 2011 Nov; 34(6): 535-546.
[7] Ditunno JF Jr, Ditunno PL, Graziani V, Scivoletto G, Bernardi M, Castellano V, et al: Walking Index for spinal cord injury (WISCI): an international multicenter validity and reliability study, Spinal Cord. 2000 Apr;38(4):234-43.
[8] Itzkovich M., Gelernter I., Viering-Sorensen F., Weeks C., Laramee MT., Carven BC, et al: The Spinal Cord Independence Measure (SCIM) version III: Reliability and validity in a multi-center international study, Disabil Rehabil. 2007 Dec 30; 29 (24):1926-33. Epub 2007 Mar 5.
[9] J. Scott, K. Rosa, M. Fu, K. Cerri, M. Peeters, M. Deumone-Mauviel, et al: Fatigue Severity Scale: Reliability, Validity and Interpretation Of Change- Evidence From Two Clinical Trials In Patients with Chronic Hcv Infection, 2013.
[10] Kuhner C, Burger C, Keller F, Hautzinger M: Reliability and validity of the Revised Beck Depression Inventory (BDI- ll). Results from German samples. Nervenarzt. 2007 Jun; 78(6):651-6.
[11] Edelle C. Field-Fote, Gerard G. Fluet, Scott D. Schafer, Eric M. Schneider, Robin Smith, Pamela A. Downey, et al: The Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI). J Rehabilitation Med. 2001 Jul; 33 (4):177-81.
[12] Craven BC, Morris AR: Modified Ashworth Scale Reliability for measurement of lower extremity spasticity among patients with SCI. Spinal Cord. 2010 Mar; 48 (3):207-13.
[13] Ida Bromley. Tetraplegia and paraplegia -A guide for physiotherapist. Churchill Livingstone. 6th Ed, July 2006.
[14] Ho CH, Triolo RJ, Elias AL, Kilgore KL, DiMarco AF, Bogie K et al: Functional electrical stimulation and spinal cord injury. Phys Med RehabilnClin N Am. 2014 Aug; 25 (3).
[15] Martin R, Sadowsky C, Obst K, Brooke M, McDonald J. Functional Electrical Stimulation in SCI - From theory to practice. Top Spinal Cord Inj Rehabil. 2012; 18(1): 28-33.
[16] Adams MM, Hicks Al: Comparison of effects of body weight supported treadmill training and tilt table standing spasticity in Individuals with chronic spinal cord injury. J Spinal Cord Med 2011; 34(5): 488-494.
[17] Tse CM, Chisholm AE, Lam T, Eng JJ: A systematic review of the effectiveness of task specific rehabilitation interventions for improving independent sitting and standing function in spinal cord injury. J Spinal Cord Med 2018; 41(3): 254-266.
[18] Hubli M, Dietz V. The physiological basis of neurorehabilitation locomotor training after spinal cord injury. Journal of Neuroengineering and Rehabilitation. 2013; 10:5.
[19] Cook AS, Woollacott MH. Motor learning and recovery of function in Motor control theory and practical applicationtions. Lippincott Williams & Wilkins. 5th Ed; 2016.
[20] Ahuja CS, Martin AR, Fehlings M. Recent advances in managing Spinal cord injury secondary to trauma. F1000 Research 2016; 5 (F1000 Faculty Rev): 1017.
Cite This Article
  • APA Style

    Priti Agni, Ankita Bhanushali. (2018). Early Intervention as an Agent for Recovery of Function After Spinal Cord Injury- A Single Case Study. International Journal of Neurologic Physical Therapy, 4(2), 34-39. https://doi.org/10.11648/j.ijnpt.20180402.12

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    ACS Style

    Priti Agni; Ankita Bhanushali. Early Intervention as an Agent for Recovery of Function After Spinal Cord Injury- A Single Case Study. Int. J. Neurol. Phys. Ther. 2018, 4(2), 34-39. doi: 10.11648/j.ijnpt.20180402.12

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    AMA Style

    Priti Agni, Ankita Bhanushali. Early Intervention as an Agent for Recovery of Function After Spinal Cord Injury- A Single Case Study. Int J Neurol Phys Ther. 2018;4(2):34-39. doi: 10.11648/j.ijnpt.20180402.12

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  • @article{10.11648/j.ijnpt.20180402.12,
      author = {Priti Agni and Ankita Bhanushali},
      title = {Early Intervention as an Agent for Recovery of Function After Spinal Cord Injury- A Single Case Study},
      journal = {International Journal of Neurologic Physical Therapy},
      volume = {4},
      number = {2},
      pages = {34-39},
      doi = {10.11648/j.ijnpt.20180402.12},
      url = {https://doi.org/10.11648/j.ijnpt.20180402.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijnpt.20180402.12},
      abstract = {This case study describes a task-specific training program for working and functional recovery in a young man with incomplete cervical spinal cord injury. The subject was 20 year old male with traumatic spinal cord injury after a fall from height. Prior to intervention, he was quadriplegic with severe motor and sensory impairment. Our goal was to recover the function. The subject underwent disectomy for anterolisthesis of C6 over C7. Acute spinal cord management was started followed by locomotor training, electrical stimulation, orthoses, specialised assistive devices. Outcome measures used were ASIA scale, walking index for SCI, SCIM, Fatigue severity scale, Beck depression scale, SCI-FAI. It was found that specific interventions were intentionally selected in the development of treatment program which helped in the functional recovery of the patient. After 3 and half months treatment, the subject was able to walk with the assistance of AFOs and walker, and was able to perform ADLs independently. The magnitude of his functional improvements could be attributed to early intervention and neuroplasticity.},
     year = {2018}
    }
    

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    AU  - Priti Agni
    AU  - Ankita Bhanushali
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    DO  - 10.11648/j.ijnpt.20180402.12
    T2  - International Journal of Neurologic Physical Therapy
    JF  - International Journal of Neurologic Physical Therapy
    JO  - International Journal of Neurologic Physical Therapy
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    AB  - This case study describes a task-specific training program for working and functional recovery in a young man with incomplete cervical spinal cord injury. The subject was 20 year old male with traumatic spinal cord injury after a fall from height. Prior to intervention, he was quadriplegic with severe motor and sensory impairment. Our goal was to recover the function. The subject underwent disectomy for anterolisthesis of C6 over C7. Acute spinal cord management was started followed by locomotor training, electrical stimulation, orthoses, specialised assistive devices. Outcome measures used were ASIA scale, walking index for SCI, SCIM, Fatigue severity scale, Beck depression scale, SCI-FAI. It was found that specific interventions were intentionally selected in the development of treatment program which helped in the functional recovery of the patient. After 3 and half months treatment, the subject was able to walk with the assistance of AFOs and walker, and was able to perform ADLs independently. The magnitude of his functional improvements could be attributed to early intervention and neuroplasticity.
    VL  - 4
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Author Information
  • Department of Neurophysiotherapy, K. J. Somaiya College of Physiotherapy, Mumbai, India

  • Department of Neurophysiotherapy, K. J. Somaiya College of Physiotherapy, Mumbai, India

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