carrshaw
1 post
Apr 03, 2009
10:45 AM
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I am wondering if anyone has used TMR on a patient with SCI. I am possibly going to be treating a young lady with L1 complete SCI in the next few weeks, and am just wondering what type of outcomes people have had with use of TMR in this area? Any comments would be appreciated.
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laurava
5 posts
May 06, 2009
7:38 PM
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My son sustained a T6 complete SCI last November. I've been using it to balance out his UE and trunk rotation ( he also had bilat scapula, 8 rib, sternum and C1 Fx's as well as collapsed lungs). I haven't seen any benefit yet with the LE. I have tried resistance of the UE to try to get movement of the LE. Unfortunately, uncontrolled spasms make it difficult for me to determine if he's getting anything results. I haven't found anyone who uses it with SCI's yet. When I mentioned TMR to the PT's at the Shepherd Center in Atlanta where he was a patient, they weren't familiar with it.
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carrshaw
2 posts
May 07, 2009
3:08 PM
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I had read an earlier post regarding your son, and wanted to let you know what I am finding working with my patient. I am currently seeing a young lady as an outpatient with T9 complete. She is still in a clamshell brace as she is only 3 months out from her injury. We are working on transfers and balance predominantly, but I am noticing a good amount of progress within sessions for overall balance improvement. I have her do the work in the upper extremities with shoulder flexion, and in the trunk what she is able to. I am doing passive motion of the LE's, although during those motions I am having her actively move into trunk flexion so as to increase have her participation in the exercises, rather than me do all the work. I have only seen her a few times, but with the gains within the session, I think there is great potential there for her to recruit the abdominals and gain some stability with that. Let me know how your son progresses, with the injuries maybe it will just take longer to see greater results. Good luck, I look forward to hearing about his progress.
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laurava
6 posts
May 08, 2009
5:34 PM
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For some reason, Jeff wasn't put in a brace by his neurosurgeon so I'm not familiar with the bracing (I'm in outpt ortho). I just do his PT when he's inbetween facilities. I like the idea of making him actively move into trunk flexion when PROM of the LE is done. I also try to get him to think about actively recruiting his muscles when I move them. He is independent in transfers and most ADL's and is returning to college down in TN in August (we're in VA). After several mos at Shepherd, he spent a month at home and then went to Woodrow Wilson Rehab for 5 wks. He will continue there in outpt for another 6-8 wks. Again, the therapists there haven't even heard of TMR. But, I'll keep experimenting on him myself. Let your patient know that there was a young lady at Shepherd with the same T9 comlete injury that missed a semester at NYU but is successfully, in her wheelchair, getting her diploma with the rest of her class this month. I'll let you know if I make any gains with the TMR.
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carrshaw
3 posts
Jun 30, 2009
3:43 PM
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Just and update on my lady with T9 complete SCI. I have been using TMR Fab 5 with her with some variation
with resistive exercise, but have seen wonderful gains with her balance and control. She still has a long way to go, but she is a musician playing the trombone and piano and consistantly had been feeling as though she was falling forward when attempting to play,
however when observing her, she was not falling forward she was going into extension of the trunk with
protraction of the shoulders and head. We started working on pushing her further into trunk extension and strengthening in that position, such as pushing her w/c backward up her ramp at home. She is now able to maintain upright seated position without back support for 60-90 seconds, she no longer has the feeling of falling forward when playing her instruments
and she has progressed into a strengthening program. Transfers and w/c mobility all progressed quickly as well. I get to work with her for a couple more months before she heads off to college and am enjoying the progress she is making in all these areas.
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Tom Dalonzo-Baker
115 posts
Jul 01, 2009
12:34 PM
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That is so cool - please keep us updated Tom
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