Spinal Cord Injury in the Paediatric Community

Spinal cord injury in the paediatric community represents approximately 4% of the total overall incidences of spinal cord injuries (SCI) annually. The majority of spinal cord injuries are as a result of motor vehicle accidents, falls from heights or as a result of sporting accidents. Neurological recovery in children with spinal cord injuries is thought to be better than in the adult population, however the chances of the development of complications such as a scoliosis (sideways curvature of the spine) is higher in the paediatric population.

7-year-old Leigh Faulkner’s life was tragically disrupted when she was involved in a motor vehicle accident on the 31st October 2014. She sustained fractures of two vertebrae with complete severing of the spinal cord and resultant paralysis from her waist down. She also suffered serious damage to her intestines, requiring emergency surgery to repair.

Leigh was admitted to Netcare Rehabilitation hospital in December 2014 where she remained for 16 weeks, receiving daily intensive physiotherapy, occupational therapy, medical and nursing care and social/emotional support to her and her family. As her legs were completely paralysed, Leigh had to undergo lots of strength training to enable her arms to do all the work for her legs, such as pushing herself in her wheelchair and transferring from the chair to bed, toilet and bath. Her trunk muscles were also affected by the level of spinal cord injury so balance retraining became a vital element in learning to move herself and perform her daily tasks. Her nutritional intake was optimised and she was started on the bowel and bladder programme that would become a life-long way of allowing her to manage her continence independently.   A play therapist was involved in the processing of the emotional trauma and adjustments that she had to deal with post the incident, while the social worker monitored the psychosocial wellbeing of her family. Leigh’s specialist equipment needs were provided for in order to maximise her independence; these will need to be continuously reviewed as her body grows and changes.

Initially completely unable to do anything for herself, though her hard work and consistent family support Leigh was able to perform all her own transfers (including getting from her wheelchair onto the floor and back again) by the time she left rehab. As she gained new skills in therapy she would take these back to her home environment on weekend home visits, so that by the time she was discharged she and her family were well equipped to cope at home. Her family were trained in the unit by the therapists and nurses as to how to help her and what she should be doing at home in terms of her on-going strengthening at home.

Once Leigh returned home to her family the next step was going back to school. This planning was initiated while still in rehab; a change of school was required for logistical reasons but Leigh is now attending the new school, where she has adapted well and is excelling. As this is a school that does not normally cater for children in wheelchairs, the school has made accommodations to meet her accessibility needs. Rehabilitation continues for Leigh, with twice weekly outpatient therapy sessions, one of them in the facilities hydrotherapy pool!

Leigh’s sheer determination and strength of character has been paramount in her recovery and her return of independence. She is one of many incredible children who pass through Netcare Rehabilitation Hospital’s paediatric unit on their journey to recovery.

Conditions that are treated in our paediatric unit include but are not limited to:

  • Traumatic brain injuries
  • Near drowning
  • Spinal cord injuries
  • Guillain-Barre syndrome
  • Orthopaedic conditions
  • Hydrocephalus and microcephaly
  • Burns
  • Poly-trauma
  • Brain tumours
  • Recovery from prolonged illness e.g. meningitis and encephalitis

Services offered at the paediatric unit:

  • Intensive acute inpatient rehabilitation physiotherapy, occupational therapy and speech therapy within the supportive hospital environment, in collaboration with the interdisciplinary team of doctors, nurses, dieticians, social workers, psychologists
  • Outpatient rehabilitation physiotherapy, occupational therapy and speech therapy services
  • Aquatic physiotherapy and occupational therapy
  • Seating clinics
  • Biodex machine/gait lab
  • A dark room for sensory and visual stimulation and modulation
  • Augmentative and alternative communication (AAC)

Effective and optimal rehabilitation is best delivered in specialised paediatric rehabilitation units. At Netcare Rehabilitation’s paediatric unit; staff are skilled and have a passion for treating children with a variety of conditions. Therapy is mainly based on a neurodevelopmental therapy and sensory integration approach. Weekly goal setting meetings are held within the team to ensure that common functional goals are targeted. Functional outcome measures are used and the scoring is done weekly to track the progress of the patient. Home and school visits are arranged and equipment/appliance recommendations are made during their inpatient stay to ensure maximal function and safe discharge.

The paediatric unit strives for a family centred approach with the aim of the team and family working together in order to achieve common goals. In addition to the child receiving rehabilitation, families are able to share the rehabilitation experience with other families on the same journey as themselves. This can afford an invaluable platform for families to provide emotional support, motivation and encouragement on the path to recovery.

For further information regarding the Paediatric Unit at Netcare Rehabilitation Hospital visit www.netcare.co.za or www.physicalrehab.co.za/auckland-park/paediatric-ward

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