Poster Sessions - 2018 Research Day

Event Title

The Effect of Six Weeks of Activity-Based Therapy on Functional Outcomes of a Geriatric Patient with Functional Quadriplegia and Multiple Co-Morbidities: A Case Report

Location

Hall of Governors

Start Date

4-6-2018 4:00 PM

End Date

4-6-2018 5:30 PM

Abstract

Background and Purpose: According to the National Spinal Cord Injury Statistical Center, the 2017 estimate for the annual incidence of spinal cord injury (SCI) in the United States was approximately 17,500 new SCI cases each year. Studies have shown that geriatric patients are particularly vulnerable to SCIs; however, there is limited research focusing on this population. The purpose of this case report is to describe the effects of activity-based therapy on functional outcomes for a geriatric patient with functional quadriplegia and multiple co-morbidities after six weeks of multidisciplinary rehabilitation, including physical therapy.

Case Description: The patient was a 77 year-old African American female who was admitted to a skilled nursing facility after hospitalization for suprapubic pain, multiple sacral pressure ulcers, and anemia. She also had functional quadriplegia secondary to complications of a cervical laminectomy one year prior. Prior to admission, the patient lived at home with family members, was non-ambulatory, and was dependent on family members for bed mobility and transfers.

Outcomes: Patient completed 29 activity-based therapy sessions, 4-5 times per week, over the course of 6 weeks. She made improvements in balance, lower extremity strength and range of motion (ROM). The Function in Sitting Test (FIST) outcome measure improved from 28/56 to 30/56 (MCID≥6.5 points) and Spinal Cord Independence Measure III (SCIM-III) improved greater than the minimal clinically important difference (MCID) from 10/100 to 18/100 (MCID: 4 points).

Discussion: The patient made significant improvements in functional outcomes after 6 weeks of progressive activity-based therapy. Despite the patient’s outcomes, the patient’s insurance did not authorize for more therapy which resulted in the patient being discharged home. Further research is needed to determine the benefits of activity-based therapy following SCI in geriatric patients, and how those may help decrease readmission rates and costs related to care.

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Apr 6th, 4:00 PM Apr 6th, 5:30 PM

The Effect of Six Weeks of Activity-Based Therapy on Functional Outcomes of a Geriatric Patient with Functional Quadriplegia and Multiple Co-Morbidities: A Case Report

Hall of Governors

Background and Purpose: According to the National Spinal Cord Injury Statistical Center, the 2017 estimate for the annual incidence of spinal cord injury (SCI) in the United States was approximately 17,500 new SCI cases each year. Studies have shown that geriatric patients are particularly vulnerable to SCIs; however, there is limited research focusing on this population. The purpose of this case report is to describe the effects of activity-based therapy on functional outcomes for a geriatric patient with functional quadriplegia and multiple co-morbidities after six weeks of multidisciplinary rehabilitation, including physical therapy.

Case Description: The patient was a 77 year-old African American female who was admitted to a skilled nursing facility after hospitalization for suprapubic pain, multiple sacral pressure ulcers, and anemia. She also had functional quadriplegia secondary to complications of a cervical laminectomy one year prior. Prior to admission, the patient lived at home with family members, was non-ambulatory, and was dependent on family members for bed mobility and transfers.

Outcomes: Patient completed 29 activity-based therapy sessions, 4-5 times per week, over the course of 6 weeks. She made improvements in balance, lower extremity strength and range of motion (ROM). The Function in Sitting Test (FIST) outcome measure improved from 28/56 to 30/56 (MCID≥6.5 points) and Spinal Cord Independence Measure III (SCIM-III) improved greater than the minimal clinically important difference (MCID) from 10/100 to 18/100 (MCID: 4 points).

Discussion: The patient made significant improvements in functional outcomes after 6 weeks of progressive activity-based therapy. Despite the patient’s outcomes, the patient’s insurance did not authorize for more therapy which resulted in the patient being discharged home. Further research is needed to determine the benefits of activity-based therapy following SCI in geriatric patients, and how those may help decrease readmission rates and costs related to care.