SPINAL CORD INJURY - PHYSIOTHERAPY & REHABILITATION

What is the spinal cord?
The spinal cord is a collection of nerves that travels from the bottom of the brain down your back. There are 31 pairs of nerves that leave the spinal cord and go to your arms, legs, chest, and abdomen. These nerves allow your brain to give commands to your muscles and cause movements of your arms and legs. The nerves that control your arms exit from the upper portion of the spinal cord, while the nerves to your legs exit from the lower portion of the spinal cord. The nerves also control the function of your organs including your heart, lungs, bowels, and bladder. For example, signals from the spinal cord control how fast your heart beats and your rate of breathing.
Other nerves travel from your arms and legs back to the spinal cord. These nerves bring back information from your body to your brain including the senses of touch, pain, temperature, and position. The spinal cord runs through the spinal canal. This canal is surrounded by the bones in your neck and back called vertebrae which make up your backbone. The vertebrae are divided into 7 necks (cervical) vertebrae, 12 chest (thoracic) vertebrae and 5 lower back (lumbar) vertebrae. The vertebrae help protect the spinal cord from injury.

What is a spinal cord injury?
The spinal cord is very sensitive to injury. Unlike other parts of your body, the spinal cord does not have the ability to repair itself if it is damaged. A spinal cord injury occurs when there is damage to the spinal cord either from trauma, loss of its normal blood supply, or compression from tumor or infection. Spinal cord injuries are described as either complete or incomplete. In a complete spinal cord injury, there is a complete loss of sensation and muscle function in the body below the level of the injury. In an incomplete spinal cord injury, there is some remaining function below the level of the injury. In most cases, both sides of the body are affected equally.
An injury to the upper portion of the spinal cord in the neck can cause quadriplegia-paralysis of both arms and both legs. If the injury to the spinal cord occurs lower in the back it can cause paraplegia-paralysis of both legs only.


A spinal cord injury (SCI) can result from trauma, such as a motor vehicle accident, violence, or a fall; or a disease or disorder, such as a tumor or virus, that affects the spinal cord's ability to send and receive messages to and from the brain. Most injuries occur from a traumatic event, according to the literature, most of these injuries occur in men.


A person with SCI typically has some paralysis and decreased or loss of sensation below the level of injury. Depending on the severity of a person's spinal cord injury, an occupational therapist can provide treatment in a hospital, clinic, or at home that allows the person to become as independent as possible. With proper treatment, thousands of people with SCI have continued to lead happy and productive lives.

How is a spinal cord injury treated?

The first goal is to relieve any pressure on the spinal cord. This could involve removing portions of the vertebrae that have broken and are compressing the spinal cord. If the spinal cord is being compressed by tumor, infection or severe arthritis, surgery can be performed to reduce the amount of compression. 
 

The second major goal of surgery for spinal cord injury is to stabilize the spine. If the vertebrae are weakened from fracture, tumor or infection, they may not be capable of supporting the normal weight from the body and protecting the spinal cord. A combination of metal screws, rods and plates may be necessary to help hold the vertebrae together and stabilize them until the bones heal.

Effects of Spinal cor injury

There are many potential complications related to spinal cord injury that may require specific treatment. These complications include:

  • Urinary Tract Infections Or Urinary Incontinence (Inability To Control The Flow Of Urine), 

  • Bowel Incontinence (Inability To Control Bowel Movements), 

  • Pressure Sores, 

  • Infections In The Lungs (Pneumonia), 

  • Blood Clots, 

  • Muscle Spasms, 

  • Chronic Pain, And 

  • Depression.

How we treat SCI

After the initial treatment and stabilization of patients with a spinal cord injury, much of the treatment is geared toward rehabilitation. This includes methods to help the patient maximize their function through physical and occupational therapy and the use of assistive devices.


Treatment for spinal cord injuries can be divided into two stages: acute and rehabilitation. The acute phase begins at the time of injury and lasts until the person is stabilized. The rehabilitation phase begins as soon as the person has stabilized and is ready to begin working toward his or her independence.


The Acute Phase
During the acute phase, it is very important that the person receive prompt medical care. The faster the person accesses treatment, the better his or her chances are at having the least amount of impairment possible. In most cases, the injured person will be sent to the closest hospital or center equipped to deal with spinal cord injuries.


The first few days of the acute stage are accompanied by spinal shock, in which the person’s reflexes don’t work. During this stage, it’s very difficult to determine an exact prognosis, as some function beyond what is currently being seen may occur later. At this stage, other complications from the accident or injury will also be present, such as brain injury, broken bones, or bruising.

The Rehabilitation Phase

Once the acute phase is over and the person has been stabilized, he or she enters the rehabilitation stage of treatment. Treatment during this phase has the goal of returning as much function as possible to the person. Because all spinal cord injuries are different, a unique plan designed to help the person function and succeed in everyday life is designed. The plan often includes:

  • Helping the person understand his or her injuries

  • Helping the person understand the details regarding his or her care

  • Helping the person become as independent as possible in everyday activities such as bathing, eating, dressing, grooming, and wheelchair use

  • Helping the person learn to accept a new lifestyle, especially pertaining to sexual, recreational, and housing options

  • Helping the person learn how to instruct caregivers on how to assist them

  • Preparing them for vocational rehabilitation

What can we do?

 

  • Evaluate a person's ability and level of functioning in his or her home, at work, and while engaging in leisure activities and hobbies.

  • Determine how motivated a person is to participate in activities that he or she participated in prior to the injury.

  • Identify any changes in roles a person may experience as a result of SCI.

  • Provide individualized therapy to retrain people to perform daily living skills using adaptive techniques.

  • Facilitate coping skills that could help a person overcome the effects of SCI.

  • Implement exercises and routines that strengthen muscles that may have been affected that are necessary for daily activities, such as dressing, eating, and taking care of a home.

  • Determine the type of assistive devices that could help a person become more independent with daily living skills.

“Start by doing what’s necessary; then do what’s possible; and suddenly you are doing the impossible.” -Francis of Assisi

What can persons with spinal cord injuries and their friends and families do?

  • Get involved in the rehabilitation process. A person with a spinal cord injury and his or her family members should be active participants in his or her recovery and rehabilitation.

  • Choose health care providers who specialize in spinal cord injury care.

  • Provide emotional support during a person's recovery and rehabilitation. Friends and family members should encourage a person with SCI so that he or she achieves and maintains as much independence as possible.

  • Use resources available to the injured persons and their families that help in understanding SCI and help in planning recovery, rehabilitation, and integration back into the community.

SUCCESS STRORIES

DINESH K JINDAL

“In 2018, I had a stroke. Since then my right arm and right leg become weak and contracted. My arm has been contracted up towards my chest,” says Dinesh K Jindal a stroke survivor. I had speech impediment. He was in outpatient therapy for 4 months doing physiotherapy, speech. He says, he had the most wonderful therapists; their experience and never-ending support was so important during his journey to recovery. While there I was introduced to Able X. It helped me start and continue to use my body balance doing all the ADL’s. Indian Stroke and Paralysis Care Centre gave me a new life.

DINESH K JINDAL

“In 2018, I had a stroke. Since then my right arm and right leg become weak and contracted. My arm has been contracted up towards my chest,” says Dinesh K Jindal a stroke survivor. I had speech impediment. He was in outpatient therapy for 4 months doing physiotherapy, speech. He says, he had the most wonderful therapists; their experience and never-ending support was so important during his journey to recovery. While there I was introduced to Able X. It helped me start and continue to use my body balance doing all the ADL’s. Indian Stroke and Paralysis Care Centre gave me a new life.

ASHOK CHAUDHARY

I was a normal active person in my routine living with my partner and children until I had my stroke. This left me unable to walk or use my left arm. I was discharged from hospital on wheelchair. I was very determined to walk again. There is light at the end of the tunnel. Take one day at a time and every day try to reach a goal, however small. I joined Indian Stroke and Paralysis Care Centre. It was really great feeling. These exercise sessions made me feel there was a life after stroke and gave me hope. I tried everything that was offered. I advise others to keep your chin up.

RAMESH KUMARI

My fall made me paralyzed not only through body but through mind as well. My recovery at Indian Stroke and Paralysis Care centre gave me a new hope, new reason to live. I was hopeless at keeping my self-active. In my deepest, darkest moments what really got me through was rehab in all possible ways. I had that glimmer of hope about my recovery at ISPC. It’s been one month since my admission and I have achieved the monthly sale goal. I am on the road to recovery.

NITI SACHDEVA

Just living is not enough but living with enthusiasm is worth living. Her secret to overcome her challenges is her vivacious nature. In search of a better health she came across Indian Stroke and Paralysis Care Centre at MSS Hospital. Now she could do everything she couldn’t while she was disabled. She says, ISPC manifested positivity, high spirits in her life. Slowly and steadily she won the race to overcome hurdles caused after stroke. She can’t Thank enough for valued assistance infact prays Indian Stroke and Paralysis Care Centre name to be multiplied to help reach out to more people in need of help for better quality of life. She encourages everyone recovering from stroke. She appreciates attention given to her by ISPC staff.

PARAMJEET SINGH

Having a stroke July 2018 changed my life completely. Stroke affected my complete right side, speech impediment. My family sensed jitteriness in my behaviour. I grew more anxious with every passing day. Lost regalement in things normally enjoys, lack energy. Stroke changed my feel about myself and did agonize over the future. It was like a feeling of worry about something with an uncertain outcome. Initially it was difficult for him to work on rehabilitation. Kindle good spirits, the words of others who have faced down the life’s challenges helped to find the will to keep fighting. He further added that Indian Stroke and Paralysis Care Centre at MSS Hospital starts treatment by doing what’s necessary, then progressing to do what’s possible and suddenly you are doing the impossible. An expression of gratitude from his wife for giving his husband a better quality of life after his stroke they could have ever imagined, motivates the team. Mr Paramjeet is working on his own. Although Paramjeet Thank us, he’s the one who deserves the credit. His consistency and enthusiasm will ensure that he keeps seeing amazing results.

SANJAY ANAND

“I think, little by little I’ll be able to solve my problems and survive”, this what Mr. Sanjay Anand thought on hospital bed when he was told stroke by the doctor’s team. He recalled saying June 2018, started out like any other day at the office with one very large exception. While seated at the desk he tilted on his left side, falling on ground. His co-workers noticed that he didn’t seem to be acting normally and asked him. He was life –flighted at the hospital where he spent 14 days, 11 of them in Neuro Intensive Care Unit. He was 58. He often feels depressed when he felt shame and sadness seeing other patients in the stroke unit walking better than him. On some days he wouldn’t even get out of the bed. He misses his daily routine from getting 5 in the morning till 11 at night. He was always on his toes. Sanjay Anand has a long road back. He is still working on his recovery but has made such remarkable progress. He could resume working and has returned to his functional activities. His family is so grateful to the wonderful therapists, doctors, and nurses of Indian Stroke and Paralysis Care Centre who have contributed to his recovery. 

SAROJ JAIN

Together we can, together we will. Her optimism and MSS therapist’s skills helped her to recover from stroke. She shares her experience with everyone in stroke unit to give them the confidence and belief. Looking back the memory lane, she says it to be a long journey from her hospital stay to wheelchair dependent to her rehabilitation. It’s like a dream come true with lots of efforts done efficiently. Team of physiotherapists at MSS prompt me and within couple of months I was able to handle myself. Not only been able to sit –stand from bed but started taking steps gradually progressing with stairs. Saroj Jain says, I have the power to do something and liberated. I was wheelchair dependent. She stands proud of her achievement when she looks at mirror. She further adds, Indian Stroke and Paralysis Care Centre at MSS Hospital treatment brought lost smile back. Her helplessness replaced with ability and now she commutes all alone from Rohini to Pitampura. Going out places is no more a challenge for her. She thanks ISPC team from the Bottom of her Heart for care and support she got. She knows that her life is now worth living and exciting.

SHASHI BALA

Shashi Bala a woman past her prime with ectomorph build marched ahead of Indian Stroke and Paralysis Care Centre at MSS Hospital on 17th Sept 2018 from Kasganj, U.P. after 7 months of CVA. She arrived by ambulance accompanied by her husband, paralysed on the right side of body and speech was garbled. She could barely hold up her head and had no balance. This sudden stroke impaired her cognitive, emotional and physical capabilities to that of a new born baby.  According to her husband, his wife condition was a major setback for him and for his family. For Shashi it was a daily struggle that greet her each morning to relearn basic functional life skills. Staff at the hospital urged Shashi to focus on what she could do not what she couldn’t do. Several weeks of rehab got her to the point where she was able to sit, stand and walk out of the place with the help of a walker. According to her husband he attributes his wife’s overall improvement to ISPC. While hospitalised, Shashi tried working out her mental muscles by repeating things she wanted to retain such as date of anniversary, date of birth, number of children etc. as task given to her in her free time. Shashi speech has just started. With her slurred speech pattern she showed her desire to get back her normal life, looking after her grandchildren, playing with them. She soon wants to re-join her Mahila Seva Samiti get together.

SUCHITA SINGH

I am a wife, a mother and a housewife. The trauma of the stroke has shaped my life in ways I was not prepared for. After a stroke the life you once had is changed forever. Through Indian Stroke and Paralysis Care Centre the journey to create a new way of living has influenced every aspect of life. They have strengthened and propelled my journey of fitness and affirmative life style. It’s been a long hard journey. ISPC gave me the power to face challenges around me. What I love to do that I thought I would never be able to do again is cooking! My life has definitely changed, but I’ve learned to embrace my new routine. With God’s grace, support from family and physiotherapists -All Things Are POSSIBLE!

“Believe you can and you’re halfway there.” –Theodore Roosevelt

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