The role of physiotherapy in recovery from generalized tetanus: two case reports
Tóm tắt
A toxin produced by Clostridium tetani causes an acute illness called tetanus. Although there are still isolated incidences of the disease in emerging nations with social and economic squalor, the number of cases has dropped as a result of vaccination. This case report intends to describe the physical therapy treatments given to two patients at the Federal Medical Center in Abeokuta who were diagnosed with generalized tetanus. A 14-year-old girl and a 7-year-old boy were admitted to the Federal Medical Centre Abeokuta (FMCA) with symptoms of tetanus including an inability to open their mouths and muscle stiffness, and they were treated by pediatric physiotherapists with a combination of soft tissue massage, passive stretching, and passive movements to improve their muscle function. The patient in case 1 showed improvement in all clinical outcomes, such as muscle spasm, hypertonicity, muscle strength in the upper and lower limbs, and overall functional status, after undergoing therapy for 14 days. Similarly, the patient in case 2 also showed improvement in the same clinical outcomes after undergoing therapy for 8 days. Specifically, both patients showed Oxford muscle grading of 4/5 on both left and right limbs, and case 1 showed a functional independence measure score of 66/126 while case 2 showed a score of 56/126. These case reports provide evidence that physical therapy interventions are effective in improving clinical outcomes and functional status in patients with generalized tetanus, and highlight the importance of incorporating physiotherapy in the management of this condition.
Tài liệu tham khảo
Brook I (2008) Current concepts in the management of Clostridium tetani infection. Expert Rev Anti Infect Ther. 6(3):327–36. https://doi.org/10.1586/14787210.6.3.327.
WHO (2017) Weekly epidemiological record. WHO 92:53–76
Lisboa T, Ho Y, Filho GTH, Brauner JS, dos Santos JL, Valiatti VJC (2011) Guidelines for the management of accidental tetanus in adult patients. Rev Bras Ter Intensiva 23(4):394–409
Moll JL, Carden DL (2016). Tetanus. Tintinalli J.E., & Stapczynski J, & Ma O, & Yealy D.M., & Meckler G.D., & Cline D.M.(Eds.), Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e. McGraw Hill. https://accessemergencymedicine.mhmedical.com/content.aspx?bookid=1658§ionid=109435736
Chalya PL, Mabula JB, Dass RM, Mbelenge N, Mshana SE, Gilyoma JM (2011) Ten-year experiences with tetanus at a tertiary hospital in Northwestern Tanzania: a retrospective review of 102 cases. World J Emerg Surg 6:20
Brauner JS, Vieira SR, Bleck TP (2002) Changes in severe accidental tetanus mortality in the ICU during two decades in Brazil. Intensive Care Med 28:930–935
Joshi S, Agarwal B, Malla G, Karmacharya B (2007) Complete elimination of tetanus is still elusive in developing countries: a review of adult tetanus cases from referral hospital in Eastern Nepal. Kathmandu Univ Med J 5:378–381
Chukwubike OA, God’spower AE (2009) A 10-year review of outcome of management of tetanus in adults at a Nigerian tertiary hospital. Ann Afr Med 8:168–172
Center for Disease Control (2011) Tetanus surveillance - United States, 2001–2008. MMWR 60:365–369
Immunization surveillance, assessment and monitoring: tetanus. http://www.who.int/immunization_monitoring/diseases/tetanus/en/index.html
Rodrigo C, Senaka FD, Rajapakse S (2014) Pharmacological management of tetanus: an evidence-based review. Crit Care 18:217
Ogunrin OA (2009) Tetanus – a review of current concepts in management. J Postgrad Med 11(1):46–61
Bleck TP, Brauner JS (1997) Tetanus. In: Scheld WM, Whitley RJ, Durack DT (eds) Infections of the central nervous system, 2nd edn. Lippincott-Raven, Philadelphia, pp 629–653
Rudolph V (1962) Medicine and physiotherapy in tetanus. S Afr J Physiother 18(3):5–7. https://doi.org/10.4102/sajp.v18i3.1006