Improving functional outcomes and quality of life in an elderly woman with sarcopenia and spinal Tuberculosis: A case report

Abstract

BackgroundIndonesia is the world's second-largest contributor to TB patients. According to prevalence by age, the elderly have the most diagnosed TB. In Indonesia, TB spondylitis affects approximately 5% of TB cases and is a common cause of non-traumatic spinal cord injury (NTSCI). Spinal cord injury (SCI) is a growing public health concern, particularly among the elderly, as many of its populations have sarcopenia. Due to the complete absence of voluntary muscle contraction, SCI is followed by a rapid loss of skeletal muscle mass. SCI has several physical, psychological, social, and economic consequences.Case presentationA 68-years-old woman presented with weakness and numbness of all four limbs. She also had sarcopenia, malnutrition, and dependency on activities of daily living (ADL). In addition, the patient was at a risk of SCI complications. Magnetic resonance imaging (MRI) showed destruction of the vertebral bodies at the level of the 5th and 6th cervical area, tuberculous abscesses of the paravertebral and longus colli muscles. The patient underwent debridement and spinal stabilization. However, the patient was at a risk of developing SCI complications. In these patients, the Physical Rehabilitation and Medicine (PRM) strategy focuses on improving medical conditions, including preventing secondary complications, promoting neurological recovery, and optimizing function.ConclusionThis case highlights the importance of PRM intervention in assessing functional disorders in the elderly to improve their quality of life (QOL).

Rehabilitation management of patients with spinal tuberculosis (Review)

“…Exercises focus on walking ability and proprioception, according to the neurological damage and the degree of recovery. They may involve assisted walking with the aid of a physical therapist and mobility aids, such as a walker or parallel bars, functional electrical stimulation to stimulate leg muscles and promote walking patterns, and seated leg extensions targeting the quadricep muscles and improve knee stability ( 16 ). In order for patients to maintain their autonomy, further assistive equipment, such as crutches, walking frames and wheelchairs may be helpful.…”

“…Additionally, patients are prescribed postural reprogramming, involving exercises to correct seated and standing postures, the stretching of tight muscles, biofeedback training utilizing devices or mirrors for visual feedback on posture alignment, and breathing exercises aimed at promoting relaxation and proper spine alignment. Patients are re-trained to perform progressive resistance training with hand resistance, resistance bands and free weights, and functional training focusing on daily living activities ( 16 ). Daily activities and QoL may be promoted by physical therapy, occupational therapy, ergonomic advices and the patient's environmental adaptation.…”