Adherence to prescriptions of therapeutic exercises in patients with traumatic spinal cord injury

Abstract

Introduction and objective. Spinal cord injury (SCI), which disrupts motor, sensory and autonomic functions, causes significant changes in the functioning of an individual. It is believed that most of the conditions secondary to SCI, i.e. osteoporosis, spasticity or cardiopulmonary diseases, are associated with immobility. The aim of the study is to assess the adherence to prescriptions of therapeutic exercises (APTE) in patients with SCI after acute phases of rehabilitation. Materials and methods. The criterionfor APTE recognition was the performance at least twice a week for a minimum of 30 minutes of active exercises with resistance, and exercises maintaining the range of movement of the joints The research tools were own questionnaire and the WHOQOL-BREF scale. Results. 46 subjects (63.9%) met the APTE criteria. The most frequent place for performing the exercises was the subject's home with 43 subjects (93.5%) with APTE performed the exercises in their homes. 17 subjects (36.9%) with APTE performed exercises during stays at various rehabilitation centres. The main cause for the lack of APTE was the limited availability of facilities considered necessary by the respondents to adhere to the instructions. In statistical analysis, the level of neurological injury correlated with meeting the APTE criteria. It was discovered that a subjective assessment of the exercise dose correlated with the place where the exercises were performed, but did not correlate with meeting the APTE criteria. Conclusions. The basic place for performing exercises (as instructed in hospital) was the subject's home. Limited access to reimbursed environmental therapy resulted in an increased cost of exercises supervised by commercially-employed physiotherapists. The current gaps in the system of supervision and counselling of subjects post-SCI necessitate changes in the Polish health care system.

Adherence to and impact of home-based high-intensity IMT in people with spinal cord injury: a pilot study

“…Further, individuals with SCI are less likely to receive general preventative care than neurologically intact individuals [ 9 ]. Insurance, lack of funds, physical entry to buildings or rooms, and transportation act as barriers to healthcare access for this population [ 9 – 12 ].

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Comparison of two inspiratory muscle training protocols in people with spinal cord injury: a secondary analysis

“…All IMT sessions were supervised in the T-IMT group, while only one session per week was supervised in the F-IMT group. There are financial, transportation, and staffing barriers that may limit the clinical translation of fully supervised training protocols [ 20 , 21 ]. However, supervision may be required for individuals with hand function impairments if adaptations are not available to allow for independent use of devices.…”

Joint hypermobility in school-aged children and adolescents with idiopathic scoliosis – A chance for more accurate screening?

“…Joint hypermobility, delayed puberty, asymmetric spinal load, placing the thoracic spine in a lordotic position, growth-related factors (greater body height and growth velocity of more than 2 cm per year), low body mass index and abnormal levels of leptin are also suspected to play a role in scoliosis development [13]. Finding the association of JH with the development of IS is an important part of medical care for children and adolescents especially from rural regions where diagnostic imaging and therapeutic intervention may be delayed due to reduced accessibility [14,15]. The diagnosis of joint hypermobility during a simple physical examination could identify children at higher risk of developing scoliosis.…”