Functional Monoplegia in the context of extensive deconditioning and spinal stenosis

Abstract

Case study of a patient (pt) presenting with positional loss of muscle tone and deep tendon reflex (DTR) of the left lower extremity (LLE). MRI identified lumbar spinal stenosis but failed to identify other disease processes accounting for the motor deficit. We hypothesized that an increase in sedentary lifestyle related to the stay at home order for the 2020 COVID-19 pandemic, superimposed on generalized deconditioning resulting in postural disturbance, led to anatomic dysfunction sufficient to block motor signals to the LLE. Conservative management including positioning, stretching, and manual therapy allowed the pt to demonstrate a return of active movement of the LLE against gravity in all major joints. This treatment protocol is presented as a novel, conservative approach to restoring functionality in a pt with a rare symptom of spinal stenosis: Functional monoplegia of a lower extremity. This case report additionally discusses the suspected functional impact of the COVID-19 stay at home order on the geriatric population.