An evidence-based approach to assessment and treatment in a patient with chronic paraplegia

A patient with spinal cord injury and traumatic brain injury was seen for outpatient physical therapy treatment for twelve visits at a University clinic from May 1, 2014 to July 17, 2014. Treatment was provided in an outpatient clinic under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with the Functional Tests for Persons who Self Propel a Manual Wheelchair, modified Functional Reach Test, and the International Standards for Neurological Classification of Spinal Cord Injury and a plan of care was established. Main goals for the patient were to increase wheelchair propulsion speed, improve seated dynamic balance, improve right upper extremity strength, and decrease right hip and shoulder pain. Main interventions used were task-specific functional and strengthening exercises, manual orthopedic therapy, and boxing interval training with rhythmic auditory stimulus. The patient achieved the following goals: improved wheelchair propulsion speed, improved seated dynamic balance, and decreased pain. The patient was discharged to continue living at home with a home exercise program.