Bisson Teresa, Newsam Craig J
a Department of Physical Therapy , Rancho Los Amigos National Rehabilitation Center , Downey , CA , USA.
b Program in Physical Therapy, University of Minnesota , Minneapolis , MN , USA.
Physiother Theory Pract. 2017 Nov;33(11):888-895. doi: 10.1080/09593985.2017.1357155. Epub 2017 Aug 9.
High intensity and frequency of task-specific practice is required to produce functional change in individuals with neurologic conditions. Self-efficacy is an important predictor of engagement in physical activity in individuals with spinal cord injury. Combining these two rehabilitation concepts has the potential for lasting functional improvement. The purpose of this case report is to describe the management of a patient with incomplete spinal cord injury (iSCI) using a model of concentrated bouts of physical therapy with an emphasis on techniques to increase self-efficacy. The patient is a 70-yr old female who sustained C5/C6 vertebral fractures in a fall, resulting in incomplete tetraplegia. She participated in a pilot program of 1 week of intensive physical therapy every 10-12 weeks over the course of 5.5 months. Interventions included functional activities important to the patient, therapeutic exercise, and home exercise program. Confidence and self-efficacy were shaped using patient-directed discussions and active problem solving. The patient improved on all measures of gait, balance, and participation, and also reported increased confidence and self-management of her condition. A high-intensity, periodic model of care delivery combined with a capacity-building approach may be an effective method to improve confidence, motivation, and function in persons with iSCI.
对于患有神经系统疾病的个体，需要高强度且高频率的特定任务练习才能产生功能改变。自我效能是脊髓损伤个体参与体育活动的重要预测指标。将这两个康复概念结合起来有可能实现持久的功能改善。本病例报告的目的是描述一名不完全性脊髓损伤（iSCI）患者的管理情况，采用一种集中进行物理治疗的模式，重点是提高自我效能的技术。患者是一名70岁女性，在一次跌倒中发生C5/C6椎体骨折，导致不完全性四肢瘫痪。在5.5个月的时间里，她每10 - 12周参加一次为期1周的强化物理治疗试点项目。干预措施包括对患者重要的功能活动、治疗性锻炼和家庭锻炼计划。通过以患者为导向的讨论和积极解决问题来塑造信心和自我效能。患者在步态、平衡和参与度的所有测量指标上都有所改善，并且还报告称对自身状况的信心和自我管理能力有所提高。高强度、周期性的护理模式与能力建设方法相结合，可能是提高iSCI患者信心、动力和功能的有效方法。
