Spinal Cord Injury (SpinalCordInjury) causes paraplegia or quadriplegia, which is often caused by trauma, and is commonly seen in traffic accidents, industrial accidents, or sports injuries, and is concentrated in large numbers in times of war or natural disasters such as earthquakes. Although most of these patients are treated in local hospitals, the loss of movement and sensation below the plane of injury caused by spinal cord injury is difficult to recover for life.
Most of them cannot take care of themselves and need to be taken care of. Due to the lack of necessary knowledge of rehabilitation care, many comorbidities (such as pressure sores, urinary tract infections, osteoporosis, spastic pain, joint contracture, heterotopic ossification, etc.) also appear, causing great pain to patients and leading to psychological imbalance, and at the same time, bringing a heavy burden to families and society. This is a series of problems that cannot be solved by clinical care.
Rehabilitation of spinal cord injury
To be precise, the practice of rehabilitation of spinal cord injury should begin with the acute treatment. There is a saying that “rehabilitation begins under the wheel, because improper or untimely resuscitation measures in the acute phase will cause permanent damage to the spinal cord.” In other words: early management of acute spinal cord injury determines the degree of prevention and lifelong disability of the patient. Therefore, it is critical to take brake immobilization before moving in field emergencies for patients estimated to have possible spinal and spinal cord injuries. In particular, reliable external fixation of cervical spine injuries is essential. This is because every rise in cervical spinal cord injury means a significant reduction in the patient’s rehabilitation goals and an increase in disability.
The rehabilitation objectives are the following.
1, prevention and active treatment of various complications.
2.To perform functional exercise and physical therapy. To improve residual muscle strength and joint mobility. In particular, the enhancement of upper limb and back muscle strength is more important. The training should pay attention to the promotion of the patient’s body balance and coordination role, as well as the use of assistive devices (such as self-help devices and supports, walkers, crutches wheelchairs, etc.) to maximize the patient’s recovery of residual function and the ability to live independently (or partially independently). To enable the patient to stand and walk again.
3. To understand the psychological condition of the patient, enhance self-sufficiency and confidence, exercise will, and provide vocational education. To enable the patient to return to society, become self-supporting and disabled.
The main contents of post-rehabilitation
1.Evaluate the condition of the whole body and make rehabilitation plan
① Muscle strength examination.
②Joint mobility examination.
③Sensory examination.
④Respiratory function examination.
⑤ daily life movement examination.
⑥reflex, balance, spasticity, sexual function, urinary system function examination.
(⑦) Mental status examination.
⑧ Family and social investigation. Of course, routine physical examination is essential.
2. Functional exercise and implementation of rehabilitation plan
(1) Disabled limb and all joints should be moved at least twice a day in a wide range of activities. Some joints of the disabled limb should be moved passively and gently, and the ankle joint should be moved daily in addition to daily activities, and foot drop should be noted when lying in bed.
(2) Recumbent exercise: practice moving the body and turning over on the mattress, strengthen the upper limb and back muscles, and enhance the strength of the residual muscles as soon as possible; certain training equipment (such as dumbbells, tensioners or special training equipment) should be available.