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Chapter-11 Rehabilitation of Neglected Spinal Cord Injuries

BOOK TITLE: Neglected Musculoskeletal Injuries

Author
1. Chhabra HS
ISBN
9788184488890
DOI
10.5005/jp/books/11171_11
Edition
1/e
Publishing Year
2011
Pages
17
Author Affiliations
1. Indian Spinal Injuries Centre, New Delhi, India, Indian Spinal Injuries Centre, New Delhi, India; ISCoS; IGASS; AO Spine; ASSI; ASCoN; SCS, Indian Spinal Injuries Center, New Delhi, India
Chapter keywords

Abstract

Spinal cord injury affects every aspect of body function. The patient has to learn the most basic activity which was simple and later complex tasks independently. He has to train himself to be usefully employed and integrated in the society. The rehabilitation should ideally start immediately on admission. The team includes spinal injury consultant, nurse, physiotherapist, occupational therapist, orthotist, psychologist, peer counselor, social worker and vocational counselor. The physical rehabilitation includes prevention of pressure ulcer, maintenance of joint range of motion, beginning of bowel and bladder programme and instituting daily activities. The patient can be mobilized as early as possible once spine is stabilized. This includes respiratory care, functional range of motion, bed mobility skills, increasing sitting tolerance, trunk balance and strengthening programme. The occupational therapist intervention include mat exercises and activities like rolling, sitting, balance training wheel chair transfer, wheel chair propulsion, hand function and ADL training. The objective of bladder management is effective and safe method of emptying the bladder and avoiding incontinence. The indwelling catheter is advocated during phase of spinal shock and clean intermittent catheterization once spinal complications such as progressive spinal deformities, spinal instability certain other complications such as spasticity, contracture, heterotopic ossification, osteoporosis and fracture need watchful observation and assistance. The respiratory complication such as repeated infections, aspiration pneumonitis, atelectasis, pneumonia and gastrointestinal complications such as constipation, abdominal distension, hemorrhoid and difficulty in bowel training need frequent attention.

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