EW is a 71-year-old man who sustained a cervical spinal cord injury following a fall in September 2022 while on holiday in Oxford. Prior to his injury, he was retired and actively involved in volunteering at a local food bank and care home, as well as raising money for charities
Following his injury, EW underwent neurosurgery at the John Radcliffe Hospital in Oxford for C1-5 fixation and wore a cervical collar for four months. After his initial recovery, he was repatriated to Worthing and spent three months in acute care. EW previously engaged in spinal rehabilitation at Stoke Mandeville for seven months and has recently been receiving community neurorehabilitation, which is currently coming to an end. He joined Vim Healthcare on 14th December 2023 for further intensive rehabilitation.
Functional Ability at Commencement with Vim Health
- Spasticity in both upper and lower limbs
- Clonus
- Reduced passive range of movement in upper limbs (greater than lower limbs)
- Reduced sensation
- Reduced strength in the arms compared to legs
- Neuropathic pain in upper limbs
- Reduced core stability
Activity and Participation Limitations:
- Requiring assistance for all activities of daily living, including eating, drinking, washing, and dressing
- Transfers into a tilt-in-space, attendant-propelled wheelchair using a hoist
- Needs assistance from two people for all bed mobility tasks
- Enjoys community access, such as attending Brighton football matches and taking walks, though this is limited by the lack of access to an adapted vehicle
- Stands daily in the Oswestry standing frame with assistance
Outcome Measures:
- Spinal Cord Independence Measure (SCIM): 15/100
Input at Vim
EW attended 107 sessions, totaling 88.81 hours over 12 months at Vim Health with both occupational therapists and physiotherapists. His rehabilitation included the following interventions:
- Upper and lower limb robotics
- Hands-on physiotherapy
- Electrical stimulation
- Functional task practice
- Intensive arm programme
- Adaptive equipment (Saebo Mini 4W)
Goals Made in Collaboration with Patient:
- Eating using hands and aids – Achieved
- Cuddling wife – Ongoing
- Exploring use of left hand to drink with – Achieved
- Steadying a book and turning the pages – Achieved (using a Kindle)
Functional Outcome:
- Able to feed himself with assistance
- Transfers to wheelchair with the use of a banana board and carer assistance
- Improved range of motion in arms
- Driving a powered wheelchair using head controls
