Physiotherapy Rehabilitation Strategies as an Adjunct to Hyperbaric Oxygen Therapy in a Patient with Diving-related Spinal Cord Decompression Sickness: A Case Report

"Decompression Sickness" (DCS) is a rare neurologic condition that is generally seen in divers which sometimes lead to decreased physical and functional capacity. The purpose of our study is to investigate the effects of a high-intensity physiotherapy rehabilitation program on the physical capacity and functional level of a patient diagnosed with DCS who had residual physical impairments. A 65-year-old male with acute incomplete T4 spinal cord injury was diagnosed with DCS when he got on the boat after 35 min of diving. He experienced acute-onset paresthesia and upon moving his lower extremities, he noted bilateral leg weakness and difficulty in standing up and walking. The physiotherapy and rehabilitation program in addition to hyperbaric oxygen therapy started on the 1st day of hospitalization and continued six times per week during the first 3 months and four times per week for the next 3 months. The motor and sensory level of the patient was evaluated by the American Spinal Injury Association. Functional independence level, static and dynamic balance ability were recorded with functional ındependence measurement and functional reach test, respectively. Clinically important improvements have been observed in the patient's muscle strength, sensation, balance ability, and ambulation parameters. Treatment of DCS should be supported by a physiotherapy rehabilitation program when there are residual physical impairments to increase functionality and prevent permanent disability. Different rehabilitation strategies must be further examined.