Efficacy of early rehabilitation in a patient with spinal cord ischemia and hypoxic-ischemic encephalopathy: a case report

Abstract

26 yaşında erkek hasta hipoksik-iskemik ensefalopati ve omurilik iskemisine bağlı tetrapleji tanısı ile Fizik Tedavi ve Rehabilitasyon (PMR) kliniğine başvurdu. Her iki durumun bir arada bulunması nadir bir durumdur. Bu çalışma rehabilitasyon uygulana hastada erken tedavinin hastanın ağır durumuna nasıl yarar sağlayacağını incelemeyi amaçlamaktadır. Motor ve fonksiyonel değerlendirmeler 8 haftalık rehabilitasyon programından önce ve sonra yapıldı. Alt ekstremite kas kuvveti ve denge durumunu değerlendirmek için biodex izokinetik kuvvet ve denge testleri kullanıldı. Ayrıca, 6 dakikalık yürüme testi yapılmış ve kavrama gücü ölçülmüştür. Üst ekstremite fonksiyonlarını değerlendirmek için Kol, Omuz ve Ellerde Engellilik İndeksi (DASH), bağımsızlık seviyesini belirlemek için Fonksiyonel Bağımsız Önlemler (FIM) Anketi kullanılmıştır. Erken rehabilitasyon programının bir sonucu olarak, hastanın motor ve fonksiyonel durumu önemli ölçüde iyileşti. Abstract A 26-year-old male patient was admitted to Physical Medicine and Rehabilitation (PMR) inpatient clinic with a diagnosis of tetraplegia due to hypoxic-ischemic encephalopathy and spinal cord ischemia. The coexistence of both conditions is a rare condition. This study aims to examine how early treatment in terms of rehabilitation would benefit the patient's severe condition. Motor and functional evaluations were performed before and after the 8-weeks rehabilitation program. Biodex isokinetic strength and balance tests were used to evaluate lower extremity muscle strength and balance status. Also, the 6-minute walking test was performed, and the pinch and handgrip strength were measured. Disability of the Arm, Shoulder, and Hands Index (DASH) was used to evaluate the upper extremity functions, and the Functional Independent Measures (FIM) Questionnaire was used to determine the independence level. As a result of an early rehabilitation program, motor and functional status of the patient improved significantly.

Keywords

• spinal cort ischemia
• balance
• isoknetic

Kaynakça

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