The Strategic Approach to the Rehabilitation of Patients with "locked in Syndrome"

Background. This article presents an evaluation of the strategic approach to managing rehabilitation for patients with cervical spinal cord injuries and "locked in syndrome". Consistent pursuit of concrete and explicit individual goals enables the patient to achieve greater independence, and thus a better quality of life. Material and methods. We examined 68 patients with tetraplegia subsequent to cervical spinal cord injury (SCI) and "locked in syndrome" under treat ment in the Cracow Rehabilitation Center, divided into two groups matched for age and sex: the experimental group (E), rehabilitated according to a stra tegic plan, and the control group (K) rehabilitated without such a plan. Outcomes were measured by clinical observation, the Functional Independence Measure (FIM), and a Self-Evaluating Scale of Progress in Rehabilitation. The patients were tested once just before beginning rehabilitation, and again 6 months later. Analysis of results. In both groups similar progress was recorded in certain parameters of the FIM scale; in group E, however, much greater pro gress was noted in terms of self-help and psycho-social functioning. The patients from group E were much more content with the results they had achieved in rehabilitation. Conclusions. The results reported here justify the assertion that the stra tegic approach to the rehabilitation of patients with cervical SCI and "locked in syndrome" makes the most of the procedures applied, without fundamental changes in procedures or additional personnel, new equipment, etc. The THE STRATEGIC APPROACH TO THE REHABILITATION OF PATIENTS WITH "LOCKED IN SYNDROME"