Post-Earthquake Spinal Cord Injury: Role of Physiotherapy and Rehabilitation

Öz

This review examines the crucial role of physiotherapy and rehabilitation in the management of post-earthquake spinal cord injuries (SCI). After an earthquake, patients with SCI require specialized and intensive rehabilitation programs to promote recovery, prevent complications, and enhance their quality of life. This article reviews the pathophysiology of post-earthquake SCI, the various clinical and functional assessments used to evaluate severity, and the different treatment options available including pharmacotherapy, surgical interventions, and rehabilitation. This review discusses the challenges and barriers faced by patients and healthcare providers, the expected outcomes and prognosis for patients, and the key findings and recommendations for future research and practice. The review emphasizes the importance of an individualized physiotherapy and rehabilitation approach to the management of post-earthquake SCI.

Anahtar Kelimeler

• Earthquake
• spinal cord injury
• physiotherapy
• rehabilitation
• assessment

Deprem Sonrası Omurilik Yaralanması: Fizyoterapi ve Rehabilitasyonun Rolü

Öz

Bu derleme, deprem sonrası oluşan omurilik yaralanmalarının tedavisinde fizyoterapi ve rehabilitasyonun kritik rolünü incelemektedir. Bir depremden sonra, omurilik yaralanması olan hastalar, iyileşmeyi desteklemek, komplikasyonları önlemek ve yaşam kalitelerini artırmak için özel ve yoğun rehabilitasyon programlarına ihtiyaç duyarlar. Bu makale, deprem sonrası omurilik yaralanmalarının patofizyolojisini, şiddetini değerlendirmek için kullanılan çeşitli klinik ve fonksiyonel değerlendirmeleri ve farmakoterapi, cerrahi müdahaleler ve rehabilitasyon dahil olmak üzere mevcut farklı tedavi seçeneklerini gözden geçirmektedir. Bu derlemede, hastaların ve sağlık hizmeti sağlayıcılarının karşılaştığı zorluklar ve engelleri hastalar için beklenen sonuçlar ve prognoz ve gelecekteki araştırma ve uygulamalar için önemli bulgular ve öneriler tartışılmaktadır. Derleme, deprem sonrası oluşan omurilik yaralanmalarının yönetiminde bireyselleştirilmiş bir fizyoterapi ve rehabilitasyon yaklaşımının önemini vurgulamaktadır.

Anahtar Kelimeler

• deprem
• omurilik yaralanması
• fizyoterapi
• rehabilitasyon
• değerlendirme

Kaynakça

1. Rathore FA, Gosney JE, Reinhardt JD, Haig AJ, Li J, DeLisa JA. Medical rehabilitation after natural disasters: why, when, and how? Arch Phys Med Rehabil. 2012;93(10):1875-81.
2. Bhattarai M, Maneewat K, Sae-Sia W. Determinants of resilience among people who sustained spinal cord injury from the 2015 earthquake in Nepal. Spinal Cord. 2018;56(1):78-83.
3. Landry MD, Singh CS, Carnie L, Stephenson F, Hill A, Hill C. Spinal cord injury rehabilitation in post-earthquake Haiti: the critical role for nongovernmental organisations. Physiotherapy. 2010;96(4):267-8.
4. Fehlings MG, Tetreault LA, Aarabi B, Anderson P, Arnold PM, Brodke DS, et al. A clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the type and timing of rehabilitation. Global Spine J. 2017;7(3 Suppl):231s-8s.
5. Burns AS, O'Connell C. The challenge of spinal cord injury care in the developing world. J Spinal Cord Med. 2012;35(1):3-8.
6. Bright T, Wallace S, Kuper H. A systematic review of access to rehabilitation for people with disabilities in low- and middle-income countries. Int J Environ Res Public Health. 2018;15(10):2165.
7. Anjum A, Yazid MDi, Fauzi Daud M, Idris J, Ng AMH, Selvi Naicker A, et al. Spinal cord injury: pathophysiology, multimolecular interactions, and underlying recovery mechanisms. Int J Mol Sci. 2020;21(20):7533.
8. Maruo S, Matumoto M. Spinal fractures resulting from the 1995 Great Hanshin Earthquake of the Kobe-Osaka area of Japan. Spinal Cord.

9. Priebe MM. Spinal cord injuries as a result of earthquakes: lessons from Iran and Pakistan. J Spinal Cord Med. 2007;30(4):367-8.
10. Fawcett JW, Curt A, Steeves JD, Coleman WP, Tuszynski MH, Lammertse D, et al. Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials. Spinal Cord. 2007;45(3):190-205.
11. Hachem LD, Ahuja CS, Fehlings MG. Assessment and management of acute spinal cord injury: From point of injury to rehabilitation. J Spinal Cord Med. 2017;40(6):665-75.
12. Bozzo A, Marcoux J, Radhakrishna M, Pelletier J, Goulet B. The role of magnetic resonance imaging in the management of acute spinal cord injury. J Neurotrauma. 2011;28(8):1401-11.
13. Schurch B, Reilly I, Reitz A, Curt A. Electrophysiological recordings during the peripheral nerve evaluation (PNE) test in complete spinal cord injury patients. World J Urol. 2003;20(6):319-22.
14. Rupp R, Biering-Sørensen F, Burns SP, Graves DE, Guest J, Jones L, et al. International standards for neurological classification of spinal cord injury: revised 2019. Top Spinal Cord Inj. 2021;27(2):1-22.
15. Baunsgaard CB, Nissen UV, Christensen KB, Biering-Sørensen F. Modified Ashworth scale and spasm frequency score in spinal cord injury: reliability and correlation. Spinal Cord. 2016;54(9):702-8.
16. Kirshblum S, Burns S, Biering-Sorensen F, Donovan W, Graves D, Jha A, et al. American Spinal Injury Association (ASIA) impairment scale (AIS). International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med. 2011;34:535-46.
17. Krassioukov A, Biering-Sørensen F, Donovan W, Kennelly M, Kirshblum S, Krogh K, et al. International standards to document remaining autonomic function after spinal cord injury. J Spinal Cord Med. 2012;35(4):201-10.
18. Bracken MB, Shepard MJ, Collins WF, Holford TR, Young W, Baskin DS, et al. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study. N Engl J Med. 1990;322(20):1405-11.
19. Chu VWT, Hornby TG, Schmit BD. Effect of antispastic drugs on motor reflexes and voluntary muscle contraction in incomplete spinal cord injury. Arch Phys Med Rehabil. 2014;95(4):622-32.
20. Maynard F, Karunas R, Waring 3rd W. Epidemiology of spasticity following traumatic spinal cord injury. Arch Phys Med Rehabil. 1990;71(8):566-9.
21. Fehlings MG, Vaccaro A, Wilson JR, Singh A, D WC, Harrop JS, et al. Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PLoS One. 2012;7(2):e32037.
22. Rajasekaran S, Kanna RM, Shetty AP. Management of thoracolumbar spine trauma: An overview. Indian J Orthop. 2015;49(1):72-82.
23. Kjell J, Svensson M. Advancing Peripheral Nerve Graft Transplantation for Incomplete Spinal Cord Injury Repair. Frontiers in Cellular Neuroscience. 2022;16.
24. Tator CH, Minassian K, Mushahwar VK. Spinal cord stimulation: therapeutic benefits and movement generation after spinal cord injury. Handb Clin Neurol. 2012;109:283-96.
25. Huang L, Fu C, Xiong F, He C, Wei Q. Stem cell therapy for spinal cord injury. Cell Transplant. 2021;30:0963689721989266.
26. Asano K, Nakamura T, Funakoshi K. Early mobilization in spinal cord injury promotes changes in microglial dynamics and recovery of motor function. IBRO Neuroscience Reports. 2022;12:366-76.
27. Wang D, Teddy PJ, Henderson NJ, Shine BS, Gardner BP. Mobilization of patients after spinal surgery for acute spinal cord injury. Spine. 2001;26(20):2278-82.
28. Hagen EM. Acute complications of spinal cord injuries. World J Orthop. 2015;6(1):17.
29. Crytzer TM, Hong E-K, Dicianno BE, Pearlman J, Schmeler M, Cooper RA. Identifying characteristic back shapes from anatomical scans of wheelchair users to improve seating design. Med Eng Phys. 2016;38(9):999-1007.
30. van Langeveld SA, Post MW, van Asbeck FW, ter Horst P, Leenders J, Postma K, et al. Contents of physical therapy, occupational therapy, and sports therapy sessions for patients with a spinal cord injury in three Dutch rehabilitation centres. Disabil Rehabil. 2011;33(5):412-22.
31. Harvey LA. Physiotherapy rehabilitation for people with spinal cord injuries. J Physiother. 2016;62(1):4-11.
32. Patathong T, Klaewkasikum K, Woratanarat P, Rattanasiri S, Anothaisintawee T, Woratanarat T, et al. The efficacy of gait rehabilitations for the treatment of incomplete spinal cord injury: a systematic review and network meta-analysis. J Orthop Surg Res. 2023;18(1):60.
33. Lin MR, Huang W, Huang C, Hwang HF, Tsai LW, Chiu YN. The impact of the Chi-Chi earthquake on quality of life among elderly survivors in Taiwan--a before and after study. Qual Life Res. 2002;11(4):379-88.
34. Burns AS, O'Connell C. The challenge of spinal cord injury care in the developing world. J Spinal Cord Med. 2012;35(1):3-8.
35. Johnston MV, Diab ME, Chu BC, Kirshblum S. Preventive services and health behaviors among people with spinal cord injury. J Spinal Cord Med. 2005;28(1):43-54.
36. Kane JC, Luitel NP, Jordans MJD, Kohrt BA, Weissbecker I, Tol WA. Mental health and psychosocial problems in the aftermath of the Nepal earthquakes: findings from a representative cluster sample survey. Epidemiol Psychiatr Sci. 2018;27(3):301-10.
37. Powell T, Li S-J, Hsiao Y, Ettari C, Bhandari A, Peterson A, et al. Investigating the aftershock of a disaster: a study of health service utilization and mental health symptoms in post-earthquake Nepal. Int J Environ Res Public Health. 2019;16(8):1369.
38. Rohwerder B. Disability stigma in developing countries. 2018.
39. Scivoletto G, Tamburella F, Laurenza L, Torre M, Molinari M. Who is going to walk? A review of the factors influencing walking recovery after spinal cord injury. Front Hum Neurosci. 2014;8:141.
40. Wichmann TO, Jensen MH, Kasch H, Rasmussen MM. Early clinical predictors of functional recovery following traumatic spinal cord injury: a population-based study of 143 patients. Acta Neurochir. 2021;163(8):2289-96.
41. Aiyer SN, Gunasekaran V, Mani L, K SS, Rajasekaran S, Shetty AP. Impact of patient counseling and socioeconomic factors on initiation of rehabilitation program in spinal cord injury patients presenting to a tertiary spine unit in India. Asian Spine J. 2021;15(3):357-64.
42. Chhabra HS, Bhalla AM. Influence of socio-economic status on access to different components of SCI management across Indian population. Spinal Cord. 2015;53(11):816-20.