2. • Previous practice during radiotherapy for MSCC was flat
bed rest
• Now once diagnosis has been made and spinal stability
assessed
• Patients able to sit up gradually to 60 degrees over period of 3-4
hours
• Monitoring symptoms
• If they walked in safely they are able to continue
mobilising
3. • Refer to physiotherapy for bed rest exercises
• Refer to orthotics for a spinal brace/collar
• Brace/collar to be fitted by orthotics prior to
commencing mobilisation
• Sit up slowly in bed to 60 over 4 hrs
• If tolerated without any deterioration in pain or
neurology
• Progress with rehabilitation & mobilisation as able
4. • Refer to the physiotherapists
• Slowly sit the patient up to 60 over 4 hrs
• If tolerated & no deterioration in pain or neurology
• Patient can start to mobilise, if able
• If unable to mobilise await physiotherapy
assessment for rehabilitation
5. • Muscle strength
• Neurological deficits
• Respiratory assessment
• Co-morbidities e.g. COPD, arthritis
• Clarification of pt’s understanding of diagnosis
• Setting realistic expectations
6. • Level of therapy in-put at WPH & afterwards
• Functional Ability
• Improvements in Ability
• Functional Outcome
• Prognosis
7. • Physiotherapy rehabilitation starts as soon as MSCC
is diagnosed
• Bed rest exercises or mobilisation
• Patients sit up or starting rehabilitation & mobilisation
while they are in hospital for radiotherapy
• To clarify what patients are able to do the
Consultants at WPH have agreed a system where all
patients are suitable for rehabilitation unless
documented otherwise
8. • Early referral to physiotherapists
• Rehabilitation can start even if unable to get out of
bed
• Monitor symptoms as patients start to sit up
• Patients can do as much as their symptoms allow
them to
• Realistic expectations
