What to look for in spinal cord injury rehabilitation?

  Spinal cord injury is the damage to the structure and function of the spinal cord caused by various injury factors, resulting in changes in motor and sensory autonomic functions below the level of spinal cord injury. Injuries involving the two lower limbs or the entire trunk are called paraplegia, while those involving parts of the trunk or other parts of the limbs are called tetraplegia. Spinal cord injuries are divided into traumatic and non-traumatic spinal cord injuries.  Spinal cord injury rehabilitation training content 1, psychological care Patients are mostly in the normal labor situation suddenly by external injuries, the mind is not prepared, often expressed as anxiety, panic, fear of life at risk, later life can not take care of themselves, no economic resources, so pessimistic and desperate, do not think about food and drink, do not cooperate with the treatment and care work. Therefore, our nursing staff should take the initiative to care for the patient in response to these situations, understand the patient’s psychological situation, encourage the patient to establish confidence in overcoming the disease, tell the patient about the basic knowledge of functional exercise of the limbs of patients with spinal cord injury and simple methods of operation, tell the patient that as long as they adhere to the exercise and treatment will achieve different degrees of functional recovery, tell the patient that maintaining a normal diet will increase the body’s resistance and prevent complications The patient should be told that maintaining a normal diet will increase the body’s resistance and prevent complications.  2.Early functional intervention Rehabilitation should be intervened as early as possible after the patient’s admission to prevent complications. It is very important to prevent joint contracture and decubitus ulcers, and to let the patient perform some active activities to prevent disuse atrophy, and to give the patient a sense of participation in training, rather than simply passively accepting treatment.  3.Good basic care Most patients with spinal cord injury are tetraplegic or paraplegic, and are prone to three major complications when they are bedridden for a long time. Therefore, good basic care and prevention of the three major complications are the basis of early rehabilitation training.  4.Prevent joint contracture The correct position of the trunk and limbs can help prevent joint contracture and bed sores. The shoulder joint should be in an external booth to reduce contracture and pain in the later stage; the wrist joint is usually fixed in a functional position with a splint; the fingers should be in a slightly flexed position, and the passive extension and flexion of the hip and knee joint should be performed 5 to 6 times a day, each time for 5 min. Put anti-spin shoes on the patient’s feet or put the ankle joint in dorsiflexion at 90° to prevent ankle flexion contracture.  5. Training of activities of daily living For tetraplegic patients with different degrees of trunk and upper limb disorders, it is especially important to train activities of daily living, such as eating, grooming, upper limb dressing, moving in bed, and gradually transitioning to moving from bed to wheelchair, which most paraplegic patients can do independently.  6. Hand function training Quadriplegic patients should train hand function most of the time. Use finger flexor shortening to develop functional muscle key fixation grip, provide patients with exercise balls or let patients actively grasp pens to train patients to grasp and finger flexion flexibility, for patients who cannot actively extend the wrist can be splinted to maintain the mobility of the joint, or passively help patients to extend the wrist joint.  7, the prevention of muscle atrophy training spinal cord injury patients can use the work muscle groups to complete the usual activities can not do to compensate for the loss of function of muscle groups, such as cervical 5 injury patients can use shoulder abduction and external rotation through gravity to make the elbow extension. Selective pulling of specific muscle groups is important for patients with spinal cord injury to accomplish functional tasks, such as pulling the cord muscle to raise the straight leg in the supine position close to 120°, which facilitates transfer activities and the wearing of socks, pants, shoes, and knee and ankle foot braces. Pulling the anterior thoracic muscles allows full posterior extension of the shoulder joint, which facilitates transfer of movement in bed and work in a wheelchair. Retraction of the hip and ankle flexors is important for walking swing and standing stability.