Paraplegia physical therapy: Difference between revisions
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'''Shoulder''' -slightly flexed;to relieve pressure on shoulder. | '''Shoulder''' -slightly flexed;to relieve pressure on shoulder. | ||
'''Elbow''' -extended. | '''Elbow''' -extended. | ||
'''Forearm''' -supinated & supported by pillow. | '''Forearm''' -supinated & supported by pillow. | ||
'''Upper arm''' -pillow between arm & chest wall. | '''Upper arm''' -pillow between arm & chest wall. | ||
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'''Hips''' -extended & slightly abducted. | '''Hips''' -extended & slightly abducted. | ||
'''Knees''' - extended but not hyperextended. | '''Knees''' - extended but not hyperextended. | ||
'''Ankles''' -neutral or mild dorsiflexion. | '''Ankles''' -neutral or mild dorsiflexion. | ||
'''Toes''' -extended | '''Toes''' -extended | ||
One or two pillows are kept between the legs to maintain abduction & prevent pressure on the bony points,i.e. medial condyles & malleoli. | One or two pillows are kept between the legs to maintain abduction & prevent pressure on the bony points,i.e. medial condyles & malleoli. | ||
Revision as of 15:30, 25 February 2012
Paraplegia
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Abhishek Singh, B.P.T [2]
Overview
Paraplegia denotes a state of paresis or paralysis of both lower limb due to psychogenic cause or interruption in any part of motor path from the cerebral cortex to & including the muscles.Often internal organs below the waist are involved.
Physical therapy
Phases Of Rehabilitation
Phase1: Immediately after spinal cord injury(SCI),there is loss of movement & function due to neurotrauma & immobilization .The main emphasis of rehabilitation is to lessen adverse effects of immobilization.It includes all therapeutic intervention during the critical & acute care stages of rehabilitation.It may lasts from a few days to several weeks,when the patient begin activities out of bed.Goal- prevention of secondary complications.
Phase2:Early rehabilitation phase.Out of bed activities are tolerated for a longer duration & patient begins to work toward specific long term goals & able to participate in therapeutic programs for minimum of 3 hours per day.
Phase3:Most active & rewarding period,efforts of weeks & months of work are realized & results can be seen.The patient gains varying level of independence in specific skills.The patient may be taught advance skills in transferring,wheel chair mobility,grooming & various Activities of daily living(ADL).
Phase4:Aimed at a smooth transition to home,patient discharged from rehabilitation centre at this stage.
Phase5:Comprises of outpatient & other follow-up services,as well as community reintegration.Individuals may return to work.
Positioning
Postural Re-education:Two pillows are generally sufficient to extend(to maintain hyper extension of spine) and support fractures of dorsolumbar spine.Pillows are adjusted in such a way that bony prominences are always free from pressure.Flexion & rotation of trunk & lower limbs are specifically avoided.
Upper Limbs Positioning
Shoulder -slightly flexed;to relieve pressure on shoulder.
Elbow -extended.
Forearm -supinated & supported by pillow.
Upper arm -pillow between arm & chest wall.
Lower Limb
Hips -extended & slightly abducted.
Knees - extended but not hyperextended.
Ankles -neutral or mild dorsiflexion.
Toes -extended
One or two pillows are kept between the legs to maintain abduction & prevent pressure on the bony points,i.e. medial condyles & malleoli.