Neuromuscular Physiotherapy Management for Paraplegia due to Non-traumatic Spinal Cord Injury: A Case Report

Abstract

Introduction: Non-traumatic spinal cord injury (SCI) refers to damage of the spinal cord without direct trauma, commonly caused by infection, tumor, vascular disorders, or degenerative conditions. Lesions at the thoracolumbar junction (Th12–L1) may result in paraplegia characterized by motor and sensory impairment below the level of injury, including lower limb weakness, impaired bladder and bowel control, reduced balance, and functional limitations. Patients are also at risk of secondary complications such as muscle weakness, spasms, restricted range of motion, contractures, and pressure ulcers. Physiotherapy plays a central role in rehabilitation through interventions aimed at preserving and improving body function, preventing complications, and promoting independence. Multimodal interventions may include infrared radiation (IRR), neuromuscular electrical stimulation (NMES), manual therapy, exercise therapy, and breathing exercises.
Objective: To describe the early clinical response to a multimodal neuromuscular physiotherapy program in a patient with paraplegia due to non-traumatic spinal cord injury at the Th12–L1 level.
Methods: This case report describes a 45-year-old female patient diagnosed with paraplegia due to non-traumatic SCI at the Th12–L1 vertebrae, treated at the Physio Sakti Clinic, Makassar.
Results: After two physiotherapy sessions, pain intensity decreased substantially, anxiety levels improved, and initial lower-limb muscle activation was observed (MMT: 0→1 in selected muscle groups). These findings highlight the early positive effects of multimodal physiotherapy on pain control and functional recovery.
Conclusion: Early neuromuscular physiotherapy using a multimodal approach can provide meaningful benefits in restoring initial function and enhancing mobility in patients with paraplegia caused by non-traumatic SCI.