Physical Rehabilitation in Transverse Myelitis: A Case Report

Abstract Transverse myelitis is basically inflammation of spinal cord which results in varying degree of symptoms like weakness in limbs, bowel bladder involvement, sensory deficits depending upon the lesion. A 52-year-old female came to outpatient department of hospital with complain sudden weakness and feeling of heaviness in bilateral lower limbs with loss of sensations in both feet and was unable to walk without support. There was also a complaint of a cotton wool-like sensation in both feet. Patient came to the outpatient physiotherapy department with complaints of paraesthesia in the plantar aspect of feet, unable to walk independently, difficulty in maintaining balance while walking indoors and outdoors, difficulty in getting up from the chair, unable to get up from the floor. During the examination by a physiotherapist, it was found that the range of motion of all the joints for the upper and lower limbs were full passively whereas there was reduced muscle strength in bilateral lower extremity and trunk muscles. Berg balance score was 15/56 along with fatigue severity scale 51/63 The rehabilitation programme was of 1-1.5 hours per day under physiotherapist guidance for 6 weeks which comprised 6 days per week for the first three weeks and then it was reduced to 3 days per week for the last three weeks. The primary goal is to improve the functional capabilities and level of fatigue of the patient. The home-based treatment protocol was also designed on tailor made protocol and was modified according to the progression of the patient's ability. The progression in functional abilities and endurance were assessed initially in the first week then after every 2 weeks consequently during the rehabilitation programme. Keywords- activities of daily living , functional training, muscle training, physiotherapy, spinal cord injury