During a lower-extremity exercise session, a patient with incomplete C6 quadriparesis reports new tingling in both hands and an overall strength decrease of one grade. The MOST appropriate action is to:

During a lower-extremity exercise session, a patient with incomplete C6 quadriparesis reports new tingling in both hands and an overall strength decrease of one grade. The MOST appropriate action is to:

• A. Modify the exercise program to accommodate change in strength
• B. Apply an ice massage prior to exercise
• C. Continue LE therapeutic exercise and use facilitation techniques to stimulate more activity
• D. Discontinue all exercises and notify the physician

Answer: (D)

When new neurological symptoms appear during therapy, stopping activity and obtaining medical input is essential. A new tingling sensation in both hands along with a drop in overall strength by one grade in someone with incomplete C6 quadriparesis suggests possible progression of the cervical injury or a new cervical pathology. Continuing exercise without evaluation could risk further neural damage, so the safest step is to discontinue the activity and notify the physician promptly for assessment, possible imaging, and guidance on next steps. Modifying the exercise without medical clearance or continuing therapy with facilitation would not adequately address the concerning signs, and applying ice or other local measures doesn’t address the potential neural progression.

When new neurological symptoms appear during therapy, stopping activity and obtaining medical input is essential. A new tingling sensation in both hands along with a drop in overall strength by one grade in someone with incomplete C6 quadriparesis suggests possible progression of the cervical injury or a new cervical pathology. Continuing exercise without evaluation could risk further neural damage, so the safest step is to discontinue the activity and notify the physician promptly for assessment, possible imaging, and guidance on next steps.

Modifying the exercise without medical clearance or continuing therapy with facilitation would not adequately address the concerning signs, and applying ice or other local measures doesn’t address the potential neural progression.