Short-duration, high-intensity bouts of physical therapy to increase self-efficacy, confidence, and function in an individual with incomplete spinal cord injury: A case report

High intensity and frequency of task-specific practice is required to produce functional change in individuals with neurologic conditions. Self-efficacy is an important predictor of engagement in physical activity in individuals with spinal cord injury. Combining these two rehabilitation concepts has the potential for lasting functional improvement. The purpose of this case report is to describe the management of a patient with incomplete spinal cord injury (iSCI) using a model of concentrated bouts of physical therapy with an emphasis on techniques to increase self-efficacy. The patient is a 70-yr old female who sustained C5/C6 vertebral fractures in a fall, resulting in incomplete tetraplegia. She participated in a pilot program of 1 week of intensive physical therapy every 10-12 weeks over the course of 5.5 months. Interventions included functional activities important to the patient, therapeutic exercise, and home exercise program. Confidence and self-efficacy were shaped using patient-directed discussions and active problem solving. The patient improved on all measures of gait, balance, and participation, and also reported increased confidence and self-management of her condition. A high-intensity, periodic model of care delivery combined with a capacity-building approach may be an effective method to improve confidence, motivation, and function in persons with iSCI