Use of the international classification of functioning, disability and health in individual rehabilitation of patients with cervical spondylotic myelopathy

  • A. M. Volyansky Military Medical Clinical Treatment & Rehabilitation Center
  • A. Yu. Kikh Military Medical Clinical Treatment & Rehabilitation Center
  • A. P. Kaliman Military Medical Clinical Treatment & Rehabilitation Center
  • T. A. Tarnavskaya Military Medical Clinical Treatment & Rehabilitation Center
  • V. I. Golovatenko Military Medical Clinical Treatment & Rehabilitation Center
  • E. A. Shapran Military Medical Clinical Treatment & Rehabilitation Center
Keywords: cervical spondylotic myelopathy, International Classification of Functioning, rehabilitation, multidisciplinary team.

Abstract

The purpose to identify the features of the use of IСF in the individual multiprofessional rehabilitation of  patient with spondylogenic cervical myelopathy.

Materials and methods. The rehabilitation process and evaluation of its effectiveness were considered on a separate example of a 38-year-old patient who was transferred to the stage of subacute inpatient rehabilitation to the Military Medical Clinical & Rehabilitation Center on the 18th day after surgery. Rehabilitation of this patient was performed during 2 stages lasting 33 and 32 days with a two-week outpatient interval between them. A categorical IFF profile of patients with spinal cord injury was used to identify patient health problems. The severity of spinal cord injury was determined using the ASIA scale. The intensity of the pain syndrome was examined using a visual-analog scale. The degree of independence of the patient was assessed using the Barthel index. Muscle strength was determined on a six-point scale (L. McPeak, 1996; M. Weiss, 1986). The level of muscle spasticity was assessed using a modified Ashworth scale (Bohannon R.W., Smith M.B., 1987). The Hospital Anxiety and Depression Scale was used to determine the degree of anxiety and depression.

Results. The article discusses the effectiveness of the application of the International classification of functioning in the individual multiprofessional rehabilitation of patient  with cervical spondylotic myelopathy, 38 years old, who was transferred to the stage of subacute inpatient rehabilitation. It was shown that the use of the ICF categorical profile significantly accelerated the identification of the main problems in the patient's health. It was found that the assessment of the dynamics of the qualifier of the ICF codes made it possible to determine the effectiveness of rehabilitation measures and record the effectiveness of the work of each specialist of a multi-professional team. The possibility of creating a final document based on the ICF about the patient's health is shown. It has been proven that the use of ICF allowed specialists of the multi-professional team to set the goals of rehabilitation and prescribe a complex of rehabilitation interventions, in turn made it possible to increase the patient's independence in self-care, improve mobility and begin recovery.

Conclusions. Identifying problems regarding the function, structure, activity and participation of a patient with spondylogenic cervical myelopathy with the help of ICF allowed the specialists of the multiprofessional team to set goals for their solution and prescribe and perform a set of rehabilitation interventions, which in turn increased the patient's independence in self-care and start rebuilding. Determining the categorical profile of ICF allowed to evaluate the effectiveness of rehabilitation of a patient with spondylogenic cervical myelopathy and showed better results in improving mobility and slightly worse achievements in increasing independence and gait recovery, indicating the need for further research to address these issues. The application of the international classification of functioning in the work of a multi-professional team allows to improve the existing system of medical care for servicemen with spinal cord injuries, accelerate the restoration of independence in everyday life and return to service.

Author Biographies

A. M. Volyansky, Military Medical Clinical Treatment & Rehabilitation Center

Сol. MS, MD, PhD, Head of the clinic (rehabilitation, occupational pathology and alternative methods of treatment)

A. Yu. Kikh, Military Medical Clinical Treatment & Rehabilitation Center

Сol. MS, MD, PhD, Head of the Military Medical Clinical Treatment & Rehabilitation Center

A. P. Kaliman, Military Medical Clinical Treatment & Rehabilitation Center

senior lieutenant MS, MD, Senior resident of the department (rehabilitation and occupational pathology)

T. A. Tarnavskaya, Military Medical Clinical Treatment & Rehabilitation Center

senior lieutenant, Head of the psychosocial rehabilitation

V. I. Golovatenko, Military Medical Clinical Treatment & Rehabilitation Center

physical therapist

E. A. Shapran, Military Medical Clinical Treatment & Rehabilitation Center

physical therapist

References

Al-Tamimi, Y. Z., Guilfoyle, M., Seeley, H., & Laing, R. J. (2013). Measurement of long-term outcome in patients with cervical spondylotic myelopathy treated surgically. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 22(11), 2552–2557. https://doi.org/10.1007/s00586-013-2965-4.

Spooren, A. I., Janssen-Potten, Y. J., Kerckhofs, E., & Seelen, H. A. (2009). Outcome of motor training programmes on arm and hand functioning in patients with cervical spinal cord injury according to different levels of the ICF: a systematic review. Journal of rehabilitation medicine, 41(7), 497–505. https://doi.org/10.2340/16501977-0387.

Bakhsheshian, J., Mehta, V. A., & Liu, J. C. (2017). Current Diagnosis and Management of Cervical Spondylotic Myelopathy. Global spine journal, 7(6), 572–586. https://doi.org/10.1177/21925682176992084.

Cifu, D.X., Kaelin, D.L., Kowalske, K.J., et al. (2016). Braddom’s physical medicine and rehabilitation. 5th ed. Philadelphia: Elsevier; 1161 p.

Flautt, W., & Westrick, R. (2015). Cervical myelopathy in a special operations soldier. The Journal of orthopaedic and sports physical therapy, 45(3), 233. https://doi.org/10.2519/jospt.2015.0403

ICF research branch. Available from: www.icf-research-branch.org/download/category/17-icf-based-case-studies.

International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Available from: https://asia-spinalinjury.org/international-standards-neurological-classification-sci-isncsci-worksheet.

Tumialán, L. M., Ponton, R. P., Cooper, A. N., Gluf, W. M., & Tomlin, J. M. (2019). Rate of Return to Military Active Duty After Single and 2-Level Anterior Cervical Discectomy and Fusion: A 4-Year Retrospective Review. Neurosurgery, 85(1), 96–104. https://doi.org/10.1093/neuros/nyy230.

Sundaramurthy Senthil Kumar, N., Lal, N., Rajalakshmi, D. (2012). Effect of Exercise Program on the Rehabilitation of Patients with Cervical Spondylotic Myelopathy. Neuroscience & Medicine. Vol. 3: 54-59. https://doi.org/10.4236/nm.2012.31008.

European Physical and Rehabilitation Medicine Bodies Alliance (2018). White Book on Physical and Rehabilitation Medicine in Europe. Introductions, Executive Summary, and Methodology. European journal of physical and rehabilitation medicine, 54(2), 125–155. https://doi.org/10.23736/S1973-9087.18.05143-2.

Published
2020-12-31
How to Cite
Volyansky, A. M., Kikh, A. Y., Kaliman, A. P., Tarnavskaya, T. A., Golovatenko, V. I., & Shapran, E. A. (2020). Use of the international classification of functioning, disability and health in individual rehabilitation of patients with cervical spondylotic myelopathy. Ukrainian Journal of Military Medicine, 1(4), 35-43. https://doi.org/10.46847/ujmm.2020.4(1)-035
Section
Current aspects of diagnosis and treatment