Spinal cord injury in infancy: activity-based therapy impact on health, function, and quality of life in chronic injury

Spinal Cord Series and Cases, 2020 · DOI: https://doi.org/10.1038/s41394-020-0261-1 · Published: February 29, 2020

Spinal Cord Injury Pediatrics Rehabilitation

Simple Explanation

This case study examines the impact of activity-based therapy (ABT) on a child who sustained a spinal cord injury (SCI) in infancy. The study focuses on how ABT affected her health, physical abilities, and overall quality of life. Before ABT, the child faced numerous medical complications and was fully dependent on caregivers for mobility. After ABT, she showed significant improvements in trunk control, respiratory function, and mobility. The findings suggest that ABT can lead to unexpected and meaningful improvements in children with chronic SCI, enhancing their physical well-being and development.

Study Duration

8 months ABT intervention, with follow-up 3-5 years post-ABT

Participants

One 3-month-old infant with cervical SCI resulting in tetraplegia

Evidence Level

Level 4: Case Report

Key Findings

1
The child demonstrated significant improvements in neuromuscular capacity, especially in head and trunk control, after participating in ABT.
2
ABT was associated with major advances in respiratory health, including a reduction in pneumonia and the elimination of the need for a percussion vest.
3
The child achieved improved physical abilities, transitioning from being fully dependent to independently propelling a manual wheelchair and engaging more actively with her environment.

Research Summary

This case report details the medical and rehabilitation history of a child who sustained a cervical SCI at 3 months of age and underwent activity-based locomotor training (AB-LT) starting at ~3 years old. Prior to AB-LT, the child experienced multiple medical complications and was dependent on caregivers for mobility. After AB-LT, the child demonstrated improvements in trunk control, respiratory function, and mobility, leading to enhanced participation in daily activities. The findings suggest that AB-LT can have a positive impact on children with chronic, severe SCI, improving their physical capacity, health, and quality of life, although further research is needed to confirm these effects.

Practical Implications

Rehabilitation Strategies

Activity-based therapies should be considered as a potential intervention for children with chronic SCI to improve neuromuscular capacity and overall function.

Early Intervention Potential

Further research is needed to investigate whether earlier intervention with ABT in infants and toddlers with SCI could accelerate improvements and reduce secondary health complications.

Quality of Life Improvement

Improvements in physical function and health through ABT can enhance the quality of life for children with SCI and their caregivers, promoting greater independence and participation.

Study Limitations

1
This study is a case report involving a single participant, limiting the generalizability of the findings to other children with SCI.
2
The study does not establish a definitive cause-and-effect relationship between AB-LT and the observed outcomes, but rather highlights a potential association.
3
The ISNCSCI exam was not used at the time of program admission due to its unreliability in children under 6 years of age, potentially limiting the precision of neurological assessment.

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