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

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.