Current Physiotherapy Assessment and Outcome Measure in Pediatric Cases: A Case Study of Extramedullary Ewing Sarcoma

Abstract

Background and Objectives: The diagnosis and treatment of intradural extramedullary (IDEM) Ewing's sarcoma, a rare spinal tumor, pose particular difficulties. Ewing's sarcoma is a tiny round cell sarcoma that exhibits variable levels of neuroectodermal differentiation in immunohistochemistry along with pathognomonic molecular findings. Intradural extramedullary Ewing's sarcoma lesions are significantly less common than spinal Ewing's sarcoma. This study aimed to evaluate current physiotherapy assessment and outcome measure of Extramedullary Ewing’s Sarcoma in teenagers according to current Evidence Based Practice (EBP). Methods: We present an immensely rare case study report of a 15-year-old teenager who was admitted to hospital with no previous medical history, complaining of gradual onset of back pain in October 2022 with visual analog scale (VAS) 6/10 radiating to bilateral lower limbs. He developed lower limb weakness since November 15, 2022, worsening to wheelchair (WC) bound on November 17,2022. Upon examination, he demonstrated paraplegia, progressive weakening of upper extremities, and impaired bladder and bowel function. Outcome measures used were Toronto Extremity Salvage Score (TESS), Disability of Arm, Shoulder and Hand (DASH) and Wheelchair Outcome Measure (WhOM). Results: The measurement results are evaluated as severely disabled for lower extremity and mild difficulty for upper extremity. WhOM showed positive value post T2 - T1 which indicated an increase in level of satisfaction. Conclusion: This case study illustrates that appropriate assessment tools are crucial in determining an effective physiotherapy management for optimal patient’s outcome.