Physical Therapy Interventions in a Patient with Nontraumatic Incomplete Spinal Cord Injury Secondary to Metastatic...

Individuals with dual cancer and spinal cord injury diagnoses present unique challenges to rehabilitation teams. This case report describes the modification of a physical therapy plan of care for an individual with incomplete spinal cord injury (iSCI) resulting from metastatic lung cancer who underwent adjunctive cancer treatment.

A 61-year-woman with small cell lung cancer and T5 iSCI presenting to inpatient rehabilitation (IPR) to address function limitations from iSCI following metastatic epidural tumor resection.

Interventions focused on task-specific training of mobility skills with modifications made to address cancer-related fatigue, promote energy conservation, and prioritize functional skills for home discharge given anticipated disease progression.

IPR length of stay was 31 days. Functional Independence Measure (FIM) total score increased from 52/133 at admissions to 106/133 at discharge. Spinal Cord Independence Measure - III (SCIM-III) total score increased from 31/100 to 55/100. Functional Assessment of Chronic Illness Therapy-Fatigue Subscale score increased from 21/52 to 41/52 reflecting reduced fatigue level compared to admission. These gains facilitated discharge home with family support.

Physical therapy plan of care required consideration of dual diagnosis, cancer-related fatigue, and patient-centered goals. Participation in IPR positively affected quality of life and ability to return home with family.