Case Report: Capitalizing on Development and Activity-Dependent Plasticity, an Interaction With Pediatric-Onset Spinal Cord Injury

Frontiers in Pediatrics, 2022 · DOI: 10.3389/fped.2022.804622 · Published: March 29, 2022

Spinal Cord Injury Pediatrics Rehabilitation

Simple Explanation

This case report describes the progress of a young boy with a spinal cord injury (SCI) from birth as he undergoes a special type of therapy called Activity-Based Restorative Therapy (ABRT). ABRT focuses on activating muscles below the injury site to help the child move and explore their environment. The boy initially received traditional therapies that restricted movement. After switching to ABRT, he showed remarkable improvements in trunk control, sitting, walking, grasping, and hand movements. This suggests ABRT may offer significant benefits for infants with SCI. The child's progress suggests that intensive, activity-based therapies can help children with spinal cord injuries develop motor skills and improve their overall development, even when started long after the initial injury.

Study Duration

9 Months

Participants

A premature male infant with incomplete upper cervical SCI

Evidence Level

Level 4: Case Report

Key Findings

1
The child demonstrated improved trunk control, progressing from needing support to sit upright to sitting independently without support for extended periods.
2
The child progressed from being unable to stand independently to walking with a reverse rolling walker, navigating obstacles and inclines.
3
The child showed advancements in upper limb and hand manipulation, improving from an inappropriate grasp to a mature pincer grasp for self-feeding.

Research Summary

This case report details the progress of an infant with a cervical spinal cord injury (SCI) who received activity-based restorative therapies (ABRT) after receiving traditional therapies with limited progress. The study highlights the impact of ABRT on improving trunk control, ambulation, and upper extremity function in a child with SCI, emphasizing the role of activity-dependent plasticity in promoting development. The findings suggest that intensive ABRT may be beneficial for infants with SCI, even when initiated in the chronic phase, leading to accelerated developmental gains across multiple domains.

Practical Implications

Therapeutic Intervention

Early and intensive ABRT may be a beneficial intervention for infants with SCI to change and accelerate the trajectory of outcomes across developmental domains.

Clinical Decision-Making

This case adds to the limited available literature to guide clinical decision-making for rehabilitation of infants with neonatal SCI.

Further Research

Further research is warranted to explore the long-term effects of ABRT on developmental outcomes in children with SCI.

Study Limitations

1
Single case report limits generalizability.
2
Lack of a control group makes it difficult to isolate the effects of ABRT.
3
The child's ongoing maturation may have contributed to the observed improvements.

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