Long-term physical therapy for neuropathic pain after cervical spinal cord injury and resting state electroencephalography: a case report

Spinal Cord Series and Cases, 2022 · DOI: https://doi.org/10.1038/s41394-022-00510-0 · Published: March 29, 2022

Spinal Cord Injury Pain Management Rehabilitation

Simple Explanation

This case report explores whether physical therapy, including walking, can improve neuropathic pain and EEG peak alpha frequency (PAF) in the long term in a patient with cervical spinal cord injury. The patient, a 50-year-old man with a cervical spinal cord injury, underwent 18 weeks of physical therapy focusing on gait, with additional intensive gait training. The study found that pain scores decreased significantly after 6 weeks, and PAF increased significantly after 4 weeks, coinciding with the start of intensive gait training.

Study Duration

18 weeks

Participants

A 50-year-old man with cervical spinal cord injury

Evidence Level

Case Report

Key Findings

1
NRS scores for the mean and maximum intensities of pain decreased significantly after 6 weeks of physical therapy.
2
ΔPAF increased significantly after 4 weeks of physical therapy, coinciding with the start of intensive gait training.
3
Improvement in PAF coincided with the start of intensive gait training, suggesting the effectiveness of aerobic exercise.

Research Summary

This case report investigated the long-term effects of physical therapy, including intensive gait training, on neuropathic pain and peak alpha frequency (PAF) in a patient with cervical spinal cord injury. The patient underwent 18 weeks of physical therapy, including intensive gait training, and the study found a significant decrease in pain intensity and an increase in PAF. The findings suggest that physical therapy, particularly intensive gait training, may be effective in reducing neuropathic pain and improving brain activity in patients with cervical spinal cord injury.

Practical Implications

Clinical Practice

Long-term physical therapy, including intensive gait training, can be considered as a potential intervention for managing neuropathic pain in patients with cervical spinal cord injury.

Rehabilitation Strategies

Integrating intensive gait training into rehabilitation programs may improve both pain management and brain activity in patients with spinal cord injury.

Further Research

Further studies with larger sample sizes are needed to confirm these findings and explore the underlying mechanisms of pain reduction and brain activity changes.

Study Limitations

1
The natural course of the disease after cervical SCI.
2
The inability to quantitatively assess the daytime activity of the patient.
3
Pain intensity affecting the amount of daytime activity throughout the intervention period.

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