Manual Therapy, Posturology & Rehabilitation Journal
Manual Therapy, Posturology & Rehabilitation Journal
Case Study

Physiotherapy in elderly with severe spinal cord injury non-operative due to osteoporosis: case report

Melo Neto, João Simão de; Gomes, Fabiana de Campos

Downloads: 1
Views: 620


Introduction: Fall is one the main causes of spinal cord injury (SCI) in the elderly and is associated with an increased number of complications. Thus, studies on this subject are of extreme importance and need for there to be progress and improvements in the rehabilitation process. Objective: Report the case of woman, 62 years old, with osteoporosis and multiple vertebral fractures in the spine, after a fall to the ground. Method: We report a case of woman, 62 years old, with osteoporosis and multiple vertebral fractures in the spine, after a fall to the ground. The Patient was admitted with a chief complaint of severe pain in the lumbar and thoracic regions, and started physical therapy distributed three times per week (10 sessions of 45 minutes/session), with period of 48 hour interval between sessions. During all sessions the Numerical Rating Scale (NRS) was used for pain measurement. Patient was submitted to assessment of fear of falling by scale Falls Efficacy Scale – International – Brazil, and quality of life using questionnaire Short Form (36) Health Survey (SF-36). Results: The patient began treatment with intense pain, but after the third session the pain ceased and remained absent until the end of treatment. Regarding the fear of falling, there was a significant reduction in the level of concern. When initiating treatment, the patient showed impaired quality of life, but after physical therapy there was significant improvement. Conclusion: The physiotherapy promoted reduction of pain, fear of falling and improved the quality of life of patient with spinal cord trauma.


Spine trauma, Physical Therapy Specialty, Fear, Quality of Life, Pain.


1. Anderle DV, Joaquim AF, Soares MS, Miura FK, Silva FL, Veiga JCE, et al. Epidemiological evaluation of patients with spinal cord injury treated surgicall on the hospital “Professor Carlos da Silva Lacaz”. Coluna/Columna. 2010;9(1):58-61.

2. Morais DF, Spotti AR, Cohen MI, Mussi SE, Melo Neto JS, Tognola WA. Perfil epidemiológico de pacientes com traumatismo raquimedular atendidos em hospital terciário. Coluna/Columna. 2013;12(2):149-52.

3. Morais DF, Melo Neto JS de, Spotti AR, Tognola WA. Predictors of clinical complications in patients with spinomedullary injury. Coluna/Columna. 2014;13(2):139-42.

4. Morais DF, Melo Neto JS de, Meguins LC, Mussi SE, Ferraz Filho JRL, Tognola WA. Clinical applicability of magnetic resonance imaging in acute spinal cord trauma. Eur Spine J. 2014;23:1457–63.

5. Melo Neto JS de, Tognola WA, Spotti AR, Morais DF. Analysis of patients with spinal cord trauma associated with traumatic brain injury. Coluna/Columna. 2014;13(4):302-5.

6. Herr KA, Mobily T, Kohout FJ, Wagenaar D. Evaluation of the faces pain scale for use with elderly. Clin J Pain. 1998;14:29-38.

7. Ferrell BA. Pain Management. Clin Geriatr Med. 2000;16(4):853-74

8. Andrade FA, Pereira LV, Souza FAEF. Mensuração da dor no idoso: uma revisão. Rev. Latino-Am. Enfermagem. 2006;14(2):271-6.

9. Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45(6):239-43.

10. Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005;34(6):614-9.

11. Camargos FFO, Dias RC, Dias JMD, Freire MTF. Cross-cultural adaptation and evaluation of the psychometric properties of the Falls Efficacy Scale - International Among Elderly Brazilians (FES-I-BRAZIL). Rev. Bras. Fisioter. 2010;14(3):237-43.

12. Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR. Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Rev Bras de Reumatol. 1999;39(3):143-50.

13. Melo Neto JS de, Cavalare ADT, Fernando FSL. Qualidade de vida em portadores de hipertensão arterial sistêmica. Ter Man. 2013;11(52):248-51.

14. Zaninelli EM, Graells XSI, Néri OJ, Dau L. Avaliação epidemiológica das fraturas da coluna torácica e lombar de pacientes atendidos no prontosocorro do Hospital do Trabalhador da UFPR de Curitiba – Paraná. Coluna/Columna. 2005;4(1):11-5.

15. Morais DF, Melo Neto JS de, Spotti AR, Meguins LC, Mussi SE, Tognola WA. Image diagnosis of patients submitted to spinal injury. J Bras Neurocirurg. 2013;24(1):33-9.

16. Bialosky JE, Bishop MD, Price DD, Robinsonc ME, Georgea SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Manual Therapy. 2009;14(5):531-8 .

17. Suzuki M, Ohyama N, Yamada K, Kanamori M. The relationship between fear of falling, activities of daily living and quality of life among elderly individuals. Nursing & Health Sciences. 2002;4(4):155-61.

18. Thuret S, Moon LDF, Gage FH. Therapeutic interventions after spinal cord injury. Nature Reviews Neuroscience. 2006;7:628-43.

588167ea7f8c9d710a8b45d6 mtprehab Articles
Links & Downloads

Man. Ther., Posturology Rehabil. J.

Share this page
Page Sections