Physical Therapy Management of a Patient Diagnosed with Transverse Myelitis: A Case Report

Background: Transverse myelitis is a rare neurological disorder affecting the spinal cord and most commonly resulting in lower extremity functional deficits. Symptoms and complications can arise quickly leading to loss of ambulation, but the effects vary in each case. While medical treatment options and diagnostic approaches are discussed in the literature, research on physical therapy interventions are relatively rare. Thus, the purpose of this case report is to provide an example for acute rehabilitative care that may help document treatment options for this condition. Case Description: Patient A was admitted to inpatient rehabilitation after being diagnosed with transverse myelitis. She presented with a severely decreased functional status, requiring a wheelchair just days after being independent and a caretaker for her husband. Interventions: Physical therapy focused on improving functional movements such as walking, transferring to and from bed, and ambulating stairs. By discharge, the patient had improved in multiple facets of functional capacity and was prepared for continued therapy at a skilled nursing facility. Outcomes at Discharge: At discharge, Patient A had met nearly all of her goals but still needed further assistance that she would not get at home with her husband. She was discharged to a skilled nursing facility in her home town where she could continue to progress her functional abilities. Discussion: While some therapeutic approaches to transverse myelitis involve breaking down functional movements and relearning them as components, this patient demonstrated progress while focusing on whole functional movements such as gait, balance, transfers, and general lower extremity strengthening.