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  4. Impact of Activity-Based Therapy on Respiratory Outcomes in a Medically Complex Child

Impact of Activity-Based Therapy on Respiratory Outcomes in a Medically Complex Child

Children, 2021 · DOI: 10.3390/children8010036 · Published: January 9, 2021

Spinal Cord InjuryPediatricsRehabilitation

Simple Explanation

This case report describes how activity-based therapy (ABT) improved the respiratory function of a young child with a severe spinal cord injury. The child, who also had prematurity and other health issues, was able to reduce his reliance on a ventilator and improve his overall development through ABT. The therapy involved locomotor training and neuromuscular electrical stimulation, which helped him gain better head and trunk control, leading to improved breathing and quality of life.

Study Duration
7 Months
Participants
One 2 year 7 month old child with cervical SCI
Evidence Level
Level 4: Case Report

Key Findings

  • 1
    Activity-based therapy (ABT) led to significant improvements in respiratory capacity, reducing ventilator dependency and improving respiratory health in a child with cervical SCI.
  • 2
    The patient developed better head and upper trunk control, which contributed to improved respiratory function.
  • 3
    The child demonstrated gains in multiple domains of development, including social, cognitive, and behavioral aspects, alongside improvements in trunk control and respiratory function.

Research Summary

This case report details the positive impact of activity-based therapies (ABTs) on a medically complex child with cervical spinal cord injury (SCI), respiratory failure, and developmental delays. Over a seven-month period, ABTs, including locomotor training and neuromuscular electrical stimulation, led to unexpected improvements in the patient's respiratory status, allowing for ventilator weaning and decannulation consideration. The intervention also resulted in improvements in head and trunk control, developmental milestones, and overall quality of life, suggesting ABTs are safe and effective for medically complex children with SCI.

Practical Implications

Clinical Practice

Consider referral to intensive ABT programs for children with complex medical history of SCI and respiratory compromise.

Rehabilitation Strategies

Implement activity-based locomotor training and neuromuscular electrical stimulation to improve respiratory function and development in children with SCI.

Family Support

Educate caregivers on strategies that reinforce progression and gains in neuromuscular capacity at home and in the community.

Study Limitations

  • 1
    Single case study limits generalizability
  • 2
    Lack of a control group
  • 3
    Potential for unmeasured confounding variables

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