Looking back on productive year in physical therapy for SMA patient

With hard work and dedication, amazing growth can be found

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by Emily Jones |

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Over the past year, we have spent time focusing on various growth areas for my patient with spinal muscular atrophy (SMA), Michael. Those include edema in his lower extremities, along with ways to improve his benefits for increased lung capacity, and improving flexibility for future strengthening.

We’ve also focused on coccyx mobilizations for improved comfort, as well as improving positioning and comfort in his new wheelchair. Michael has exhibited significant improvement in reducing his edema, as well as increasing flexibility, and is finding comfort in his new wheelchair.

The edema in his feet has improved by wearing compression stockings as well as having specific lymphatic drainage techniques performed on his feet and legs during physical therapy. While our skillful massage therapists have worked to reduce the edema in his feet on a weekly basis, now Michael is able to recline and elevate his feet in his new wheelchair.

This change in position is helpful to continue to aid in circulation which benefits the lymphatic drainage. Although Michael hasn’t been able to wear his compression stockings weekly over the past year, they are applied when able which also continues to aid in circulation and reduce edema.

Michael also discovered during a yearly exam that his lung capacity has increased over this past year; this is something that is not commonly reported with SMA.  Unsure of exactly what has helped the most, we know the work we performed with stability and mobility with Michael could have significantly played a role in these improvements. Usually, over the years, people with SMA become weaker and experience more difficulty with increasing lung capacity.

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Another topic this year has been looking forward to the future with new treatments possibly coming out soon. We hope Michael will be able to partake in a new treatment within the next year or two that will allow for increase in strength, and we have been preparing by increasing extensibility throughout his lower extremities. This is to allow for more range of motion when strengthening is something we may be able to begin.

Pain in Michael’s right hip and tailbone area has been bothersome over the past year, although we were able to subside the pain with a number of activities, including internal and external coccyx mobilizations. When Michael transitioned into his new wheelchair, the new cushion didn’t allow for the reduced pressure on his right hip like the old cushion, therefore, he experienced an increase in pain and pressure in that area. After performing dry needling, shockwave treatment, as well as external manipulations, and allowing for time to adjust to the new cushion, Michael was able to feel more comfortable.

We look forward to what the next year will bring and what we will be able to accomplish. We will continue to progress as Michael tolerates and keep an open line of communication to ensure his goals are kept first.

Patient perspective

I often ask myself where would I be if I didn’t have the amazing medical staff that I have in my life. While I have great doctors, I’m most thankful for my physical therapist. Emily, along with the other staff at my physical therapy outpatient clinic, have been incredible.

Emily is not just my physical therapist, she’s also a very close friend. If I have a problem, I know she’s going to be there, and I hope and pray others with SMA either have or will find a physical therapist they can work with weekly.

Taking an FDA-approved treatment for SMA is great, but if you’re not following up with physical therapy, then you’re missing out. Remaining flexible and keeping your muscles as long and extended as possible will benefit those of us with SMA, especially when muscle-targeted therapies become available.

I want to personally thank Emily and the staff at ClearCut ORTHO in Fort Worth, Texas. 2023 was an incredible year, and I don’t know where I’d be without you.