Spinal cord injuries are structural/functional damage to the spinal cord caused by a variety of different injury factors, resulting in changes in movement, sensation, and function below the level of injury. The potential for recovery from spinal cord injury is high. Early recovery occurs within days to 6 months; patients may also have further recovery for about 2 years thereafter. The presence of early movement of the distal limb, such as active movement of the toes, often indicates good recovery potential. Spastic movements are of no prognostic value. Those with sensation at the site of paralysis have a better chance of recovery of motor function. Areas with normal sensation have a greater than 50% chance of motor recovery. Active functional exercise makes a 100% effort for a 1% hope. Even if the disease history is long, there must be great potential with rehabilitation.
I. Specific contents of rehabilitation treatment
(1) Physical therapy: including muscle strength training, balance training and coordination training; posture and transfer training; weight reduction and weight reduction training; standing and walking training, wheelchair training; physiotherapy, myoelectric biofeedback therapy, etc.
(2) Occupational therapy: including activities of daily living training, recreation and work training, etc.
(3) Application of orthotics: including ankle-foot orthotics, knee-ankle-foot orthotics, etc., and upper limb orthotics.
(4) psychotherapy: including some psychological guidance, and biofeedback therapy.
Second, the common rehabilitation training content and methods of spinal cord injury
1.turning training
For patients with complete spinal cord injury limb paralysis and upper limb function is applicable. The purpose is to.
(1) prevent pressure sores caused by prolonged local pressure on the body.
(2) Prevent and control pulmonary infections.
(3) To improve the patient’s mobility in bed.
2.Sit up training
Applicable objects are the same as turning training. The purpose is to.
(1) improve the ability to live independently on a daily basis and to complete activities such as eating, dressing and undressing and studying in a sitting position.
(2) lay a good foundation for further training.
3.Sitting balance training
Applicable objects are the same as turning training, and the purpose is the same as sitting up training. Specific methods.
(1) The patient sits with legs straight.
(2) Slowly raise the hands upward, then lower them, repeatedly carry out lifting and releasing activities, and gradually extend the lifting time.
4.Support decompression and mobility training
It is applicable to patients with complete injury of cervical 7~thoracic 2 and normal or basically normal function of upper limbs. The purpose is to.
(1) increase the support of the two upper limbs.
(2) reduce localized pressure on the body from body weight to avoid decubitus ulcers.
(3) improve the ability to move the body in bed.
Specific methods: forward movement training; the patient sits on the bed, legs straight, hands behind to support the bed; hands forcefully support the hips to lift off the bed and move forward. To move to the side training: the patient sits on the bed, legs straight, hands on both sides of the body to support the bed; hands forceful support, hips lift off the bed and move to the side.
5.Transfer training
It is applicable to paraplegic patients with some function or normal function of upper limbs. The purpose is to.
(1) Complete the transfer between the bed and the wheelchair to create conditions for using the wheelchair.
(2) Improve the ability to live independently.
Specific methods.
Assisted transfer training (transfer from wheelchair to bed): The trainer faces the patient and holds both knees against the patient’s knees; the patient holds the trainer’s shoulders with one hand and the other hangs down naturally; the trainer holds the patient’s buttocks with both hands and lifts the patient with force; the patient is helped to transfer to bed slowly.
Forward transfer training (from the wheelchair to the bed): the wheelchair is facing the side of the bed; the patient puts his legs on the bed; the patient holds the armrest of the wheelchair with both hands and supports it with force, and moves his hips from the front of the wheelchair to the bed. Lateral transfer training: the wheelchair is inclined to the bed at an angle of 45 degrees and the wheelchair is gated; the patient supports the bed with one hand and the outer armrest of the wheelchair with the other hand, so that the hips leave the wheelchair and transfer to the bed.
6.Standing training
(1) Stand up training
The trainer faces the patient, stands with legs apart, holds both hands under the patient’s armpits and lifts upward with force; the patient wears orthotics on the lower limbs, leans forward and stands up with force supporting the crutches.
(2) Standing training in parallel bars
The patient’s lower limbs with orthotics, holding the parallel bar with both hands to stand (other firm fixtures such as railings can be used in the home instead); the trainer holds the patient’s hip with one hand and the patient’s chest with the other hand; the patient stands straight with the chest up, and the standing time is gradually extended, 20-30 minutes per standing.