I. Definition and common causes of spinal cord injury
Paraplegia: It is a series of syndromes caused by the loss of neurological functions below the plane of damage on both sides caused by transection damage of the spinal cord. In today’s society, spinal cord injury is commonly caused by car accidents, falls from height, sports sprains, etc. It can also be secondary to myelitis, spinal vascular disease, spinal cord tumors, etc.
Second, the main functional disorders and common complications caused by spinal cord injury
1, paralysis: thoracic and lumbar injuries lead to paralysis of the lower limbs, and neck injuries can lead to quadriplegia.
2, sensory impairment: paralyzed limbs are usually accompanied by corresponding sensory impairment or loss.
3.Incontinence: it causes urinary leakage or retention of urine.
4, abnormal sensation: many patients feel pain, numbness, burning, cold, tightness and other abnormal sensations below the injury site.
5, muscle spasm: often appear below the plane of injury muscle tension increased, joint activity stiffness.
6, pressure sores: is the most common complication, often difficult to cure, seriously affecting the quality of survival of patients.
7, other: urinary tract infection, autonomic dysfunction, postural hypotension, joint contracture, thrombosis, heterotopic ossification, respiratory distress, etc.
III. Prognosis
Spinal cord injury recovery potential is large. The earlier the world of rehabilitation treatment is carried out after injury, the better the recovery effect and the shorter the average hospital stay. The early recovery process is within a few days to 6 months; patients can also have further recovery opportunities in the following 2 years or so. The presence of early movement of the distal limb, such as active movement of the toes, often indicates good recovery potential. Those with sensation in the paralyzed area have a better chance of recovery of motor function. Areas with normal sensation have a greater than 50% chance of motor recovery. Even if the disease history is long, there must be great potential with rehabilitation training.
Fourth, the different stages of PT treatment after injury
(A) Acute instability phase (after injury or within 4 weeks after internal spinal fixation)
Rehabilitation training mainly includes the following.
1.correct body position placement and regular turning to prevent pressure sores
2.Suction function training
Including thoracic breathing and abdominal breathing training; postural sputum evacuation training and passive thoracic movement training. The function is to enhance thoracic mobility, increase lung capacity and promote coughing up sputum to ensure the smoothness of the respiratory tract.
3.Whole body joint mobility training
The function is to maintain the normal range of joint movement, prevent joint contracture, promote blood circulation, and prevent limb edema.
4.Strength enhancement training
Role: It can improve cardiopulmonary function and prepare for various position changes, transfers, and use of wheelchairs or walkers in the future.
(II) Acute stabilization period (in about 4 to 12 weeks)
During this period, on the basis of the previous training, gradually increase the intensity of training by.
(1) Postural adaptation training
Including supine to sitting up, sitting position maintenance and transition training from prone to standing position with the help of electric rising bed.
(2) Balance function training
Including balance ability in long sitting position, end sitting position and kneeling position. To enhance the patient’s ability to live independently in bed and wheelchair.
(3) Muscle stretching training
Effects: It can help to control abnormal muscle tone, inhibit spasm and maintain normal range of motion of joints.
(4) Muscle strength training
Continue to strengthen the normal limb strength and enhance the residual muscle strength of the paralyzed limb. Active-assisted or resistance strength training can be carried out with the help of pulleys, equipment, etc.
(C) chronic phase (after 12 weeks)
All types of spinal cord injuries should be continued on the basis of the rehabilitation content of the acute phase, strengthening the training of walking ability, wheelchair ability and the ability to perform activities of daily living, strengthening psychological rehabilitation, and various education and training for the purpose of returning to the family and society.
In 5, the center PT hall for spinal cord injury patients exist functional disorders, the introduction of a series of advanced rehabilitation treatment equipment, such as paralysis rehabilitation robot, Pavel apparatus, sky track system, weight loss running table training, upper and lower limbs linkage power bicycle, etc., to provide maximum assistance for the rehabilitation of patients. The Heart PT Hall has introduced a series of advanced rehabilitation treatment equipment, such as paralysis rehabilitation robot, Pavel apparatus, sky track system, weight loss running table training, upper and lower limb linkage power bicycle, etc., to provide maximum help for patients’ recovery, in response to the functional disorders existing in spinal cord injury patients.