Unexpected clinical and functional recovery in patients with chronic traumatic chronic spinal cord injury: a case series

Authors

  • Suvarna Ganvir Department of Neuro-physiotherapy, DVVP’s COPT, Ahmednagar, Maharashtra, India
  • Gaurav Toshniwal Department of Neuro-physiotherapy, DVVP’s COPT, Ahmednagar, Maharashtra, India
  • Maheshwari Harishchandre Department of Neuro-physiotherapy, DVVP’s COPT, Ahmednagar, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241564

Keywords:

Spinal cord injury, Rehabilitation, Functional recovery, Traumatic spinal cord injury, Chronic spinal cord injury

Abstract

Motor recovery in traumatic spinal cord injury (tSCI) is reported to reach its plateau by 1 year and maximum recovery period is reported to be 2 years. Acute rehabilitation is very well documented in literature with patients reporting for functional rehabilitation immediately after shock period is over. However, the scenario being a bit different in rural areas with comparatively less awareness about role of physiotherapy, patients with tSCI reports at later stages. Reported here is a series of chronic tSCI cases who showed remarkable clinical and functional recovery in short time. Aim of this study is to report recovery in patients with chronic tSCI and to compare the patient outcomes with expected outcomes. Conventional physiotherapy was given 5 days a week with minimum 45 mins treatment. Baseline assessment at admission and at discharge was recoded. Improvement was recorded with spinal cord independence at different time points. Nine patients below 40 years of age, average duration of injury 6.2 years were treated for average of 8 months. NLI did not change in 3 patients whereas in 6 patients NLI moved 2 segments down. Mean change in SCIM score was 10 between admission and discharge. Functional status was compared with expected parameters and was found to be improved by 70%, suggesting had they come at early stage, expected recovery could have been achieved. Clinical and functional recovery in patients with tSCI may occur even after 2 years post injury.

References

Katoh H, Yokota K, Fehlings MG. Regeneration of spinal cord connectivity through stem cell transplantation and biomaterial scaffolds. Front Cell Neurosci. 2019 ;13:248.

Maynard FM, Reynolds GG, Fountain S, Wilmot C, Hamilton R. Neurological prognosis after traumatic quadriplegia. Three-year experience of California Regional Spinal Cord Injury Care System. J Neuro Surg. 1979;50(5):611-6.

O'Sullivan SB, Schmitz TJ, Fulk GD. Physical Rehabilitation, 6th edition, Faculty Bookshelf. 2014;85.

Curtis KA, Tyner TM, Zachary L, Lentell G, Brink D, Didyk T, et al. Effect of a standard exercise protocol on shoulder pain in long-term wheelchair users. Spinal Cord. 1999;37(6):421-9.

Harvey L. in Chapter 2 A framework for physiotherapy management. London: Churchill Livingstone. 2008.

Gordon T, Mao J. Muscle atrophy and procedures for training after spinal cord injury. Phys Ther. 1994;74(1):50-60.

Panisset MG, Galea MP, El-Ansary D. Does early exercise attenuate muscle atrophy or bone loss after spinal cord injury? Spinal Cord. 2015;54(2):84-92.

Anjum A, et al. Spinal cord injury: pathophysiology, multimolecular interactions, and underlying recovery mechanisms. Int J Mol Sci. 2020;21(20):7533.

Piepmeier JM, Jenkins NR. Late neurological changes following traumatic spinal cord injury. J Neurosurg. 1988;69:399-402.

Waters RL, Adkins RH, Yakura JS. Definition of complete spinal cord injury. Paraplegia. 1991;29(9):573-81.

Waters RL, Adkins RH, Yakura JS, Sie I. Motor and sensory recovery following complete tetraplegia. Arch Phys Med Rehabil. 1993;74(3):242-7.

Mathur N, Jain S, Kumar N, Srivastava A, Purohit N, Patni A. Spinal cord injury: scenario in an Indian state. Spinal Cord. 2015;53(5):34952.

Marrya M, Umar M, Ain SQ. Effectiveness of task specific training in improving functional independence after spinal cord injury. Rawal Med J. 2018;43(2):245.

Kirshblum S, Millis S, McKinley W, Tulsky D. Late neurologic recovery after traumatic spinal cord injury. Arch Physical Med Rehabil. 2004;85(11):1811-7

Fisher CG, Noonan VK, Smith DE, Wing PC, Dvorak MF, Kwon B. Motor recovery, functional status, and health-related quality of life in patients with complete spinal cord injuries. Spine. 2005;30(19):2200-7.

Chhabra HS, Sharma S, Arora M. Challenges in comprehensive management of spinal cord injury in India and in the Asian Spinal Cord network region: findings of a survey of experts, patients and consumers. Spinal Cord. 2018;56(1):717.

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Published

2024-05-31

How to Cite

Ganvir, S., Toshniwal, G., & Harishchandre, M. (2024). Unexpected clinical and functional recovery in patients with chronic traumatic chronic spinal cord injury: a case series. International Journal of Research in Medical Sciences, 12(6), 2089–2094. https://doi.org/10.18203/2320-6012.ijrms20241564

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Section

Case Series