Fourteen‑year change in activities of daily living of a quadriplegic, ventilator‑managed patient injured by high cervical spinal cord injury during infancy: a case report

BMC Pediatrics, 2022 · DOI: https://doi.org/10.1186/s12887-022-03573-y · Published: September 1, 2022

Spinal Cord Injury Pediatrics Rehabilitation

Simple Explanation

This case report describes the long-term change in ADL over time in a girl with severe high CSCI from an injury during infancy. Rehabilitation for quadriplegia, respiratory dysfunction, and autonomic neuropathy was started on the fifth day after the injury while she was in the intensive care unit. Afterwards, she continued to acquire skills through writing training using a mouse stick, computer operation training, and electric wheelchair operation training, which enabled her to improve her ADL despite her severe disability.

Study Duration

14 Years

Participants

A quadriplegic, ventilator-managed patient

Evidence Level

Level 4, Case Report

Key Findings

1
Training that utilizes current technology and changes in the environment that are appropriate for daily life are important for improving the ADL of children with severe CSCI.
2
The early introduction of a wheelchair and self-mobility for children with SCI had a positive impact on the children’s ability to learn, participate with peers, increase self-confidence, and reduce depression
3
The improvement in her FIM score after entering a support school can be attributed to the introduction of a robot that assisted her in eating.

Research Summary

This case report describes the rehabilitation of a child with severe high CSCI sustained in infancy. Despite the fact that the child required a ventilator and was severely disabled with C3 complete quadriplegia, she was able to improve her ADL by continuing rehabilitation as she grew. This case report is the first long-term demonstration that appropriate rehabilitation techniques using the latest technology can improve the QOL of patients with high CSCI. Through our experience with her rehabilitation, we have realized the importance of national and local government support for people with disabilities.

Practical Implications

Technology Integration

The integration of assistive technologies like mouse sticks, electric wheelchairs, and meal-assistance robots can significantly improve the ADL and QOL of children with severe CSCI.

Early Intervention

Early introduction of mobility aids and rehabilitation is crucial for fostering independence, learning, and social participation in children with SCI.

Environmental Adaptation

Tailoring the environment to accommodate the specific needs of individuals with CSCI, including school, home, and transportation, is essential for their overall well-being and integration into society.