Physical and Occupational Therapy for a Teenager with Acute Flaccid Myelitis: A Case Report

ABSTRACT

Aims: The purpose of this case report is to describe the inpatient rehabilitation program of a 13-year-old boy with acute flaccid myelitis (AFM), specific to physical and occupational therapy examination, treatment, and outcomes. Case Description: AFM is a rare, acute neurologic illness in children and young adults who present with weakness and/or paralysis of unknown etiology. The teenager was admitted to the program, dependent for all mobility and self-care. Interventions focused on range of motion, transfer training, self-care, power wheelchair mobility, and environmental adaptations. Outcomes: Weekly re-evaluations and the WeeFIM were used at admission and discharge to measure the teenager's progress. At discharge, the teenager had made small gains in his passive and active range of motion. He was independent in directing his care and able to drive his power wheelchair with supervision. Discussion: Due to the scarcity of published data describing AFM, this report describes an individual's response to a rehabilitation program and will hopefully add to future research in order to provide patients and families with expectations for their recovery and ultimate level of function.

KEYWORDS:

• Acute flaccid myelitis
• case report
• physical therapy
• occupational therapy
• rehabilitation
• child

Declaration of Interest

The authors report no declarations of interest.

Acknowledgments

The authors thank the child and his family for participating. The authors also thank Kristie Bjornson, PT, PhD, PCS and Cathy Graubert, PT, clinic manager, for their guidance and support.

About the Authors

Tracy Kornafel, DPT, PCS is a physical therapist on the inpatient rehabilitation unit at Seattle Children's Hospital. Elaine Y. Tsao, MD is a physical medicine and rehabilitation physician at Seattle Children's Hospital. Emily Sabelhaus, MS, OTR/L is an occupational therapist on the inpatient rehabilitation unit and the constraint induced therapy team at Seattle Children's Hospital. Lori Surges, MS, OTR/L is an occupational therapist on the inpatient rehabilitation unit and outpatient department at Seattle Children's Hospital. Susan D. Apkon, MD is the director of rehabilitation medicine and a physical medicine and rehabilitation physician at Seattle Children's Hospital.