BL joined VIM Health on the 9th February 2023 for a burst of intensive rehabilitation. He was involved in an RTC on 27 November 2022 in which he sustained the following injuries: Central Cord Syndrome with subsequent evolving left leg weakness and numbness in both hands Acute wedge fractures of L3, L4 and the left L3 and L4 transverse processes with associated soft tissue swelling, possible disruption of the anterior longitudinal ligament in the cervical and lumbar spine, a shallow anterior epidural haematoma from L2-L5, and equivocal signal changes in the thoracic cord anteriorly.
BL was acutely managed at Royal Sussex County Hospital where his injuries were managed conservatively. He received community rehab from CNRT from the 29th December 2023 once weekly for 1 month.
Functional ability at commencement with VIM Health
On initial assessment BL was using a walking stick for outdoor mobility and was unable to drive. He struggled with day-to-day tasks involving hand dexterity ie doing up buttons, cutting food, brushing teeth. He was unable to look after his grandchildren as he did previously and required regular rest throughout the day due to fatigue. BL was also finding it difficult to engage in previous leisure activities such as outdoor walking and DIY.
Input at VIM
BL was Initially seen for intensive physiotherapy input of 49.5 hours over 4 weeks. This was reduced to 34 hours over 3 months, following which he attended once a month for 4 months for a maintenance programme. From January 2023 to present he has been seen twice weekly for 1 hour plus sports massage.
BL received OT and Physiotherapy input. This included hands on neuro physiotherapy and strength and conditioning training in conjunction with NMES, UL robotics, Hydrotherapy and Sports massage.
Goal made in collaboration with patient
- To eat full meals with both hands as prior to accident. – achieved
- To pick up a glass and walk to the table without spilling – achieved
- To change bed sheets and make the bed. – achieved
- To walk into Brighton from his house with no aids. – Is walking outdoors with no aids across varied terrain – including around London (2-3 miles)
- To improve pain in his wrist (currently 8/10). – 6/10 current
- To feel confident with all outdoor activities – has returned to lawn mowing, hedge cutting, digging.
- improve Cardio Vascular (CV) fitness to pre incident levels – ongoing, feels improving. Feels about 70%. Walked 2 1/5 – 3 miles yesterday. Previously would have managed 5 miles.
- Get back to swimming independently in local pool – achieved
Outcome measures
Arm A; initial 9, improved to 4
Arm B; initial 35, improved to 8
Berg Balance Assessment; initial 47, improved to 56
9HPT Left UL; initial 75 seconds, improved to 40 seconds
Functional ability
BL is currently mobile unaided and can walk for approximately 3-5 miles. He has returned to driving. Mr Lear has resumed looking after his grandchildren and partaking in DIY activities – certain aspects of this still present a challenge at times.
