Skip to main content Skip to main navigation menu Skip to site footer

Telerehabilitation of spinal cord injury in limited resources setting during COVID-19 pandemic: A case report

  • Azharuddin ,
  • Diaz Novera ,


Abstract

Link of Video Abstract: https://youtu.be/f6IaLnu3sz8

 

Introduction: Spinal cord injury (SCI) rehabilitation is a resource-intensive and time-consuming process and this is problem in particular for patients from a rural, remote areas, or low socioeconomic backgrounds. This problem is further exacerbated by social restriction policies in place due to coronavirus disease 2019 (COVID-19). This case report aimed to describe how telerehabilitation could overcome these challenges

Case presentation: A 20-year-old female involved in a motor vehicle accident. Preoperative magnetic resonance imaging (MRI) indicated  a complete burst fracture of the L1 vertebral body. The patient experiences paraplegia and loss of autonomic control. Long spine fusion was performed. After being discharged, the patient could only visit the hospital once one-month post-surgery due to personal financial reasons and COVID-19-related social distancing policy. Telerehabilitation was used for the remaining follow-ups and rehabilitation programs were monitored through instant messaging platform between the patient, the operating surgeon, and the rehabilitation specialist. Telerehabilitation using instant messaging was an affordable and practical platform of communication for patient self-reporting and monitoring of progress. With intensive telerehabilitation program, the patient’s functional abilities recovered from Frankel B to D after 6 months of following the domiciliary telerehabilitation plan.

Conclusion: We report a case of satisfactory functional outcome of SCI rehabilitation following the use of instant messaging to assist the rehabilitation. This highlights that instant messaging may be utilized to guide the rehabilitation process with the consideration of other factors such as the patient's engagement and the healthcare provider’s commitment. We recommend for further refinements in the adoption and use of telerehabilitation for  orthopaedic and traumatology cases that need long-term rehabilitation.

Keywords: Burst fracture rehabilitation spinal cord injury telemedicine telerehabilitation

References

  1. Nas K, Yazmalar L, Şah V, Aydın A, Öneş K. Rehabilitation of spinal cord injuries. World J Orthop. 2015 Jan 18;6(1):8-16. doi: 10.5312/wjo.v6.i1.8.
  2. Furlan AD, Irvin E, Munhall C, Giraldo-Prieto M, Fullerton L, McMaster R, Danak S, Costante A, Pitzul K, Bhide RP, Marchenko S, Mahood Q, David JA, Flannery JF, Bayley M. Rehabilitation service models for people with physical and/or mental disability living in low- and middle-income countries: A systematic review. J Rehabil Med. 2018 Jun 15;50(6):487-498. doi: 10.2340/16501977-2325.
  3. Øderud T. Surviving spinal cord injury in low income countries. Afr J Disabil. 2014 Aug 26;3(2):80. doi: 10.4102/ajod.v3i2.80.
  4. Tederko P, Middleton J, Mycielski J, Joseph C, Pagliacci MC, Rapidi CA, Tarnacka B, Kujawa J. Relationship Between Level of Economic Development, Age, and Etiology of Spinal Cord Injury: A Cross-Sectional Survey From 22 Countries. Arch Phys Med Rehabil. 2021 Oct;102(10):1947-1958. doi: 10.1016/j.apmr.2021.04.024.
  5. Pacheco Barzallo D, Oña A, Gemperli A. Unmet health care needs and inequality: A cross-country comparison of the situation of people with spinal cord injury. Health Serv Res. 2021 Dec;56 Suppl 3(Suppl 3):1429-1440. doi: 10.1111/1475-6773.13738.
  6. Dorjbal D, Zanini C, Tsegmid N, Stucki G, Rubinelli S. Toward an optimization of rehabilitation services for persons with spinal cord injury in Mongolia: the perspective of medical doctors. Disabil Rehabil. 2021 Jul;43(15):2200-2212. doi: 10.1080/09638288.2019.1696415.
  7. Hajjioui A, Fourtassi M, Boujraf S. Spinal cord injury in the Moroccan healthcare system: A country case study. IBRO Neurosci Rep. 2021 Jan 7;10:62-65. doi: 10.1016/j.ibneur.2020.12.003.
  8. Pilusa S, Myezwa H, Potterton J. Environmental factors influencing the prevention of secondary health conditions among people with spinal cord injury, South Africa. PLoS One. 2021 Jun 25;16(6):e0252280. doi: 10.1371/journal.pone.0252280.
  9. Moshi H, Sundelin G, Sahlen KG, Sörlin A. Quality of life of persons with traumatic spinal cord injury in rural Kilimanjaro, Tanzania: a community survey. Disabil Rehabil. 2021 Oct;43(20):2838-2845. doi: 10.1080/09638288.2020.1718780.
  10. Prabowo NA, Megantara MA, Apriningsih H. The role of N-acetylcysteine in decreasing neutrophil-lymphocyte ratio in COVID-19 patients: A double-blind, randomized controlled trial. Narra J. 2023 May 19;3(2):e121. doi: 10.52225/narra.v3i2.121.
  11. Sharun K, Tiwari R, Yatoo MI, Natesan S, Megawati D, Singh KP, Michalak I, Dhama K. A comprehensive review on pharmacologic agents, immunotherapies and supportive therapeutics for COVID-19. Narra J. 2022 Dec 14;2(3):e92. doi: 10.52225/narra.v2i3.92
  12. Martin-Hughes R, Vu L, Cheikh N, Kelly SL, Fraser-Hurt N, Shubber Z, Manhiça I, Mbendera K, Girma B, Pambudi I, Ríos J. Impacts of COVID-19-related service disruptions on TB incidence and deaths in Indonesia, Kyrgyzstan, Malawi, Mozambique, and Peru: Implications for national TB responses. PLOS Global Public Health. 2022 Mar 30;2(3):e0000219. doi: 10.1371/journal.pgph.0000219.
  13. Winardi W, Wahyuni H, Hidayat M, Wirawan A, Nurwidya F, Uddin MN, Yusup M. Challenges on tuberculosis care in health care facilities during COVID-19 pandemic: Indonesian perspective. Narra J. 2022 Aug 1;2(2):e80. doi: 10.52225/narra.v2i2.80.
  14. Bhattarai M, Limbu S, Sherpa PD. Living with spinal cord injury during COVID-19: a qualitative study of impacts of the pandemic in Nepal. Spinal Cord. 2022 Nov;60(11):984-989. doi: 10.1038/s41393-022-00812-y.
  15. Azharuddin, A., Novera, D. Management of Spinal Cord Injury During COVID-19 Era. Bali Medical Journal, 2021 Nov;10(3):909-911. doi: 10.15562/bmj.v10i3.2430.
  16. Solomon RM, Dhakal R, Halpin SJ, Hariharan R, O'Connor RJ, Allsop M, Sivan M. Telerehabilitation for individuals with spinal cord injury in low-and middle-income countries: a systematic review of the literature. Spinal Cord. 2022 May;60(5):395-403. doi: 10.1038/s41393-022-00797-8.
  17. Chaet D, Clearfield R, Sabin JE, Skimming K. Council on Ethical and Judicial Affairs American Medical Association. Ethical practice in Telehealth and Telemedicine. J Gen Intern Med. 2017 Oct;32(10):1136-1140. doi: 10.1007/s11606-017-4082-2.
  18. Su Z, Li C, Fu H, Wang L, Wu M, Feng X. Review of the development and prospect of telemedicine. Intelligent Medicine. 2022 Nov. doi: 10.1016/j.imed.2022.10.004.

How to Cite

Azharuddin, & Novera, D. . (2023). Telerehabilitation of spinal cord injury in limited resources setting during COVID-19 pandemic: A case report. Bali Medical Journal, 12(2), 2345. https://doi.org/10.15562/bmj.v12i2.4555
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
3

Total
3

Share

Search Panel

Azharuddin
Google Scholar
Pubmed
BMJ Journal

Diaz Novera
Google Scholar
Pubmed
BMJ Journal