Spinal cord injuries (SCI) are a rare but catastrophic injury that can occur as a result of infections, tumors, or ischemic damage, and are one of the most deadly results of high-speed accidents or sporting activity. Younger people are the more at risk since they are more likely to engage in risky activities, although SCI can affect anyone at any age. Car and motorcycle accidents account for the biggest number of injuries and owing to the complicated picture after this injury a multi-disciplinary team of professionals is needed to guarantee the patient gets the highest level of independence for their unique condition. Quadriplegia and paraplegia are names used to characterize the disability that results.
The purpose of the initial medical evaluation is to determine the patient’s respiratory state and to address any other potential multiple injuries. Once the patient is stabilised, the doctors try to figure out where the damage happened in the spine, which is crucial information for medical and treatment care. Because a low lumbar fracture has little effect on the arms or ability to breathe, the patient will acquire independence with good trunk and arm strength and aerobic abilities. Cervical and upper thoracic injuries limit the patient’s capacity to breathe and limit arm function, making recovery much more difficult. Check out Physiotherapy Management Of Low Back Pain.
The first step is to determine the severity of the injury, which is critical because it determines the course of medical and physical treatment. There should be minimal, if any, respiratory implications if the spine is cracked low in the back, and the patient will have complete power in their arms and chest to gain independence. If the injury is severe, such as in the thorax or neck, the patient’s capacity to breathe spontaneously may be compromised, resulting in a considerably more difficult rehabilitation period with restricted independence.
Respiratory physiotherapy entails analysing a patient’s breathing skills, teaching them to deep breathe and fully expand their lungs, and coughing to expectorate. If the lower abdomen is paralysed, the patient may need to use their arms to stabilise the area and allow a propulsive cough to take place. When coughing, the physiotherapist can help more handicapped persons stabilise by assisting the air to leave abruptly. To induce a cough, a cough assist machine can be employed, and respiratory suction may be used in the early stages of treatment in intensive care.
A spinal surgeon will stabilise the spine if it is unstable, which is common in spinal trauma that results in paraplegia. This is commonly done with instrumentation and bone grafting. This enables the patient to begin therapy sooner rather than later as the spinal fractures mend naturally. The goal of early physiotherapy is to keep track of the patient’s breathing, stimulate active movement in unaffected areas, and execute passive motions in paralysed body parts in order to maintain and enhance ranges of motion that will be needed later for independence.
By raising the back of the bed, the physiotherapist will gradually move the patient into a more upright position. The patient’s blood pressure can drop unexpectedly if he or she gets up too soon, which must be avoided, thus the patient is eventually moved onto a wheelchair with a slanted back and elevating leg supports. Gradually, they become more erect, and they can begin to practise sitting balance on a plinth, as trunk control is typically lacking, and it must be acquired before arm and trunk strengthening, as well as wheelchair transfers, can be safely practised.
The patient should be routinely transferred to a unit that specialises in spinal injuries at this time, as they will have mastered trunk control in sitting, wheelchair transfers, and strengthening exercises. To encourage the highest level of independence, kids can get expert assistance from the interdisciplinary team on the enormous number of skills they need to learn. Many factors influence whether a patient can live a totally independent life, including age, other medical issues, family support, drive and attitude, and the extent of spinal damage. Some persons with more severe lesions may require round-the-clock care from a group of caregivers.