Physical

Therapy for a 47-year old Male with Traumatic Spinal Fractures

Status Post a Motor Vehicle Accident
Lauren Wu
Advisor: Linda M. Hall
Doctoral Program in Physical Therapy, Central Michigan University

Background and Purpose Interventions Outcome Measures

• Spinal burst fractures are common injuries in motor vehicle accidents (MVA) • 60 minute sessions for 5 days per week for 2 weeks Initial Discharge Status
• Burst fractures occur with high impact axial loading through the spine • Strengthening including isometrics and progressive resistance
• Fragments of the vertebral body are crushed and spread in all directions • Balance training, including static and dynamic activities in single and double Functional Independence Measure
• Unstable fractures require surgical fusion and decompression stance, and on level and non-level surfaces
• Physical therapy in post-operative patients can be effective in decreasing long- • Soft tissue mobilization including functional massage and stretching Transfers 4 6 Improvement
term impairments and increasing functional independence • Gait training on level and non-level surfaces
• The purpose of this case report is to document the physical therapy • Treadmill training with progressive speed, duration, resistance, incline, Walking 4 6 Improvement
interventions used in treating a patient’s functional impairments as a result of directional changes, and dual-tasking
a traumatic burst fracture Wheelchair 5 6 Improvement

Stairs 4 6 Improvement

Berg Balance Scale

Case Description
51/52 56/56 Improvement
Patient History & Review of Systems
• 47-year old male was a restrained passenger injured in a high-impact MVA Tinetti Gait and Balance Assessment
Days post-MVA Event Description
24/28 28/28 Improvement
• Sternal fracture
• L4 spinal burst fracture
• 4-12th left ribs fractures
0 Onset of Injury
• T10-T12 transverse process fractures
• T12 spinous process fracture
• L1-L3 spinous transverse process fractures Outcomes
• L4 vertebroplasty and dural repair
• L3-L5 decompressive laminectomy
• Improvement in all categories of the Functional Independence Measure,
• L2-L3 and L5-S1 bilateral cannulated
1 Surgical Intervention indicating increased independence
pedicle screws
• Improvement on the Berg Balance Scale and the Tinetti Gait & Balance
• L2-S1 bilateral rods
• posteromedial fusion Assessment, indicating decreased fall risk
• The patient was discharged to home with family care and outpatient physical
• Physical and Occupational Therapy
2 Acute Care Services therapy services 3 days per week
evaluation and treatment
9 Acute Care Discharge • End of Acute Care Services with goals met
• Referral to Inpatient Physical and
Transfer to Inpatient
14 Occupational Therapy services
Rehabilitation
• Present evaluation
Summary/Conclusion
Clinical Impressions & Evaluation
• The patient was found to have unstable levels of pain, decreased balance, • The current study agrees with literature supporting physical therapy
strength, endurance, and increased soft tissue tightness interventions to treat patients post spinal fusion to address impairments
• The patient was determined to be a good candidate for physical therapy Exercises to increase single leg stance static and dynamic balance and relating to surgery and prolonged periods of decreased mobility
coordination using cones and weighted balls