Physiotherapeutic intervention in motor disorders due to a prolonged exposure to high temperatures

Autori

Di Dio Antonio [Università di Messina, Messina, Italia]

Cavallaro Filippo [Università di Messina, Messina, Italia]

Sposito Francesca [Università di Messina, Messina, Italia]

Signorino Amelia [Università di Messina, Messina, Italia]

Di Marco Giada [Università di Messina, Messina, Italia]

Saraceno Silvia [Università di Messina, Messina, Italia]

Bonanno Francesco [Università di Messina, Messina, Italia]

Introduction to clinical case

“Rossana was unconscious on the ground in her room on the first floor of the house surrounded by flames, we don’t know if she realized about the fire….”.  It was 25 July when relatives found her unconscious, tried to cool her down, and called for help. Rossana had been exposed to the heat for more than 10 hours before being taken to hospital. She was admitted in isolation to neurology for suspected encephalitis. After three weeks, the family asks why she is not proposed physiotherapy. They find no answer and call a trusted physiotherapist.

Methods

The physiotherapist, after the anamnesis, decides to give some common sense physiotherapy advice. First of all to hydrate the body, because the activity of any living being or structure needs water. After that, he assessed her free movements, that are minimal and not very fluid, and her muscular hypotrophy. The skin was dry and the muscles were stiff. The physiotherapist, guided by clinical reasoning, performed a slowly and safety axial roll on the bed, and suggests to the patient to touch actively parts of her body with her hands. Having ascertained that the vital parameters are good, a change from supine to sitting posture, trunk check exercises, verticalization and walking training were proposed.

Results

After 3 weeks of physiotherapy, thanks to active-assisted kinesis and several exercises of control and proprioception, the patient showed an improvement in skin status, muscle elasticity and active range of motion (AROM). The body tissues conditions were the goal for the recovery of elasticity, trophism and muscle tone.

Discussion and clinical relevance

The patient showed a unique condition due to the prolonged exposure to high temperature that has dehydrated every body structure. For these clinical cases there are no physiotherapy or rehabilitation intervention guidelines. Every decision is made relying on discussion with colleagues and patients, in order to perform slow interventions with long periods of rest, only verifying the possibility of execution without requiring activity against resistance. This case report highlights how sometimes physiotherapists face realities and patients far from the classical rehabilitation fields. For this reason we suggest to implement rehabilitation intervention practices for these “outsiders”.

REFERENCES

Mario Lizza – la fatica di essere sani – Seusi