PMID- 31170347
OWN - NLM
STAT- MEDLINE
DCOM- 20200102
LR  - 20200102
IS  - 1592-7830 (Print)
IS  - 1592-7830 (Linking)
VI  - 41
IP  - 2
DP  - 2019 May
TI  - [Implementation of the ICD-ICF model in rehabilitation medicine: report of a 
      clinical case in neuromotor rehabilitation].
PG  - 156-161
AB  - We present the clinical case of a 17-year-old boy who, after an auto-motorbike 
      collision, suffered of bilateral condylar atlo-occipital dislocation with blood 
      in the medullary canal and contusion of the C1-C3 spinal cord, hemothorax and 
      pneumothorax, multiple costal fractures, fractures processes transverse L1 and 
      right iliac wing and displaced fracture of the middle third of the right femur. 
      In the emergency phase the patient, who was in a coma GCS: 3/15, was immediately 
      intubated and taken to the Emergency Department and subsequently to Intensive 
      Care Unit. He was also immediately subjected to chest drainage, reduction of 
      femoral fracture and placement of external fixator and tracheostomy. Upon 
      stabilization of the clinical picture, the patient was subjected to 
      occipital-cervical stabilization with plates and screws and reduction of the 
      fracture of the right femur with an intramedullary rod. Then the patient in 
      hemodynamically stable and in alert condition, in spontaneous breath, was 
      discharged and transferred to our Operative Unit of Intensive 
      Neurorehabilitation. At the entrance, the doctor's evaluation, with the whole 
      multidisciplinary team, enabled to identify the ICD-9 and ICF codes that best 
      described the severity of the clinical picture: the patient showed tetraplegia, 
      dysphonia and dysphagia, bearing a tracheal cannula in breath spontaneous with O2 
      supplementation, sequelae of multiple costal fractures and right femur, totally 
      dependent on ADL. The rehabilitation intervention was aimed at promoting motor 
      recovery in the 4 limbs, recovery of standing and walking, acquisition of ability 
      to control daily life activities (ADL), recovery of physiological swallowing and 
      removal of the tracheostomy tube. After long and slow physiotherapeutic training, 
      the patient recovered the active motility at the crural and brachial level mainly 
      at the proximal level, which however is not effective for ADL recovery. On the 
      other hand, speech therapy allowed the passage to oral feeding and removal of the 
      tracheostomy tube. Upon discharge, the re-evaluation of the ICF codes identified 
      at the entrance indicated an improvement in the strength of the trunk muscles 
      (b7305) with the possibility of performing transfers with assistance (d420), of 
      dysphonia (b320) and of swallowing (b510) which led to the removal of the PEG and 
      the tracheostomy tube; unfortunately severe deficiency of the muscular force at 
      the distal brachial and crural level (b730, b7304) persists with severe 
      disability in the activities of daily life (d455, d4551, d465, d429, d230).
CI  - Copyright(c) by Aracne Editrice, Roma, Italy.
FAU - Castronovo, Gioacchino
AU  - Castronovo G
AD  - Istituti Clinici Scientifici Maugeri IRCCS, UO di Neuroriabilitazione 
      Intensiva/UO Risveglio, Sciacca (AG), Italy.
FAU - De Palo, Angela
AU  - De Palo A
AD  - Istituti Clinici Scientifici Maugeri IRCCS, UO di Neuroriabilitazione 
      Intensiva/UO Risveglio, Sciacca (AG), Italy.
FAU - De Cicco, Domenico
AU  - De Cicco D
AD  - Istituti Clinici Scientifici Maugeri IRCCS, UO di Neuroriabilitazione 
      Intensiva/UO Risveglio, Sciacca (AG), Italy.
LA  - ita
PT  - Case Reports
PT  - Journal Article
TT  - Implementazione del modello ICD-ICF in medicina riabilitativa: presentazione di 
      un caso clinico in riabilitazione neuromotoria.
PL  - Italy
TA  - G Ital Med Lav Ergon
JT  - Giornale italiano di medicina del lavoro ed ergonomia
JID - 9712708
SB  - IM
MH  - Accidents, Traffic
MH  - Activities of Daily Living
MH  - Adolescent
MH  - Disability Evaluation
MH  - Humans
MH  - International Classification of Diseases
MH  - International Classification of Functioning, Disability and Health
MH  - Male
MH  - Nervous System Diseases/physiopathology/*rehabilitation
MH  - Neurological Rehabilitation/*methods
MH  - Patient Care Team/organization & administration
MH  - Spinal Cord Injuries/*rehabilitation
OTO - NOTNLM
OT  - ICF
OT  - disability
OT  - motor rehabilitation
OT  - speech and swallowing rehabilitation therapy
OT  - spinal cord injury
COIS- The authors of this article have no conflict of interests to disclose.
EDAT- 2019/06/07 06:00
MHDA- 2020/01/03 06:00
CRDT- 2019/06/07 06:00
PHST- 2019/02/01 00:00 [received]
PHST- 2019/05/31 00:00 [accepted]
PHST- 2019/06/07 06:00 [entrez]
PHST- 2019/06/07 06:00 [pubmed]
PHST- 2020/01/03 06:00 [medline]
AID - S12/2019 [pii]
PST - ppublish
SO  - G Ital Med Lav Ergon. 2019 May;41(2):156-161.