Abstract
A 30-year old woman with a traumatic thoracic spinal cord injury sustained 12 months ago was seen for 8 sessions for outpatient physical therapy treatment. Treatment was provided by a student physical therapist under direct supervision of a licensed physical therapist. The patient was evaluated at the initial encounter using the International Standards for Neurological Classification of Spinal Cord Injury, Modified Ashworth Scale, Modified Functional Reach Test, Push-up Test, Medicine Ball Throw Test, maximum strength using a hand-held dynamometer, 6-Minute Push Test, Wheelchair Skills Test-Questionnaire, Spinal Cord Injury Independence Measure, Spinal Cord Injury Spasticity Evaluation Tool, and the Quality of Life Index- Spinal Cord Injury III Version. The patient presented with paresis and spasticity in both lower extremities, impairments with dynamic sitting balance, upper and lower extremity strength deficits, cardiovascular endurance deficits with wheelchair propulsion, impaired ability to perform different types of transfers from her wheelchair, and limitations in independence levels with community outings and activities daily living. Physical therapy treatment was provided 2-3 times weekly for three weeks and consisted of functional, task-specific strengthening using experience-dependent motor learning and overload principles. A daily home exercise program for endurance, strength, sitting balance, and wheelchair skills training was implemented and adhered to. Improvements were found in the patient’s independence with functional activities and self-reported quality of life. She was discharged from outpatient physical therapy to continue living at home and to continue her home exercise program.