The results of rehabilitation on motor and functional improvement of the spinal tuberculosis.
OBJECTIVE
To evaluate the result of rehabilitation on motor and functional improvement in spinal tuberculosis.


METHODS
Prospective case study. Data were collected from 47 patients with spinal tuberculosis medically and/or surgically treated, and rehabilitated over 6 months of period, after spinal decompression and fusion. The main outcome measures were motor development of the patients who were evaluated at the beginning, in the 1st week, in the 3rd month, and in the 6th month. Functional development of the patients was evaluated at the beginning and in the 6th month. Functional assessment was made according to Modified Barthel Index (MBI), and motor examination was made according to American Spinal Injury Association (ASIA).


RESULTS
The study population consisted of 47 patients (22 males and 25 females) mean aged 37.9 +/- 18.3 years (range 5-76 years). The most common site of spinal tuberculosis was the thoracic region. Localized back pain, paraparesis, sensory dysfunction and fever were typical clinical manifestations. Surgical management was performed as anterior or posterior drainage of abscess and/or stabilization of the spine. The rehabilitation program was performed in all patients during the preoperative, early postoperative and late postoperative 6 month periods. Muscle-strengthening exercises on necessary localization such as pectoral, abdominal, lower extremities; truncal and sacrospinal extensors were started for the rehabilitation. The motor score for the lower limbs and the MBI scores for activities of daily living (ADL) and mobility improved significantly (P < 0.001). The self-care and mobility categories of the MBI on admission; were 14.8% severely dependent and 10.6% independent. However, at the end of the rehabilitation program, 4.2% were severely dependent and 70.2% independent.


CONCLUSIONS
Early diagnosis and appropriate medical and/or surgical treatment together with a rehabilitation program will improve the life quality of patients with spinal tuberculosis.
Physical Medicine and Rehabilitation, Dicle University School of Medicine, Diyarbakir, Turkey. knas@dicle.edu.tr
Kemal
K
Nas
M Serdar
MS
Kemaloğlu
Remzi
R
Cevik
Adnan
A
Ceviz
Serdar
S
Necmioğlu
Yaşar
Y
Bükte
Abdülkadir
A
Cosut
Abdurrahman
A
Senyiğit
Ali
A
Gür
A Jale
AJ
Saraç
Umit
U
Ozkan
Gökhan
G
Kirbaş
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011446:Prospective Studies; D012720:Severity of Illness Index; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000503:physiopathology / Q000628:therapy*
D000995:Antitubercular Agents