Handling Patient with Spinal Cord Injury

Summary

Persons with spinal cord injury (SCI) exhibit deficits in volitional motor control and sensation that limit not only the performance of daily tasks but also the overall activity level of these persons. The acute exercise responses and the capacity for exercise conditioning are directly related to the level and completeness of the spinal lesion. Appropriate exercise testing and training of persons with SCI should be based on the individual’s exercise capacity as determined by accurate assessment of the spinal lesion.
Persons with complete spinal lesions below the T10 level will generally display injuries to the lower motor neurons within the lower extremities and, therefore, will not retain the capacity for neuromuscular activation by means of electrical stimulation. Persons with paraplegia also exhibit reduced exercise capacity and increased heart rate responses (compared with the non-disabled), which have been associated with circulatory limitations within the paralysed tissues. The recommendations for endurance and strength training in persons with SCI do not vary dramatically from the advice offered to the general population. Systems of functional electrical stimulation activate muscular contractions within the paralysed muscles of some persons with SCI. Coordinated patterns of stimulation allows purposeful exercise movements including recumbent cycling, rowing and upright ambulation. Exercise activity in persons with SCI is not without risks, with increased risks related to systemic dysfunction following the spinal injury. These individuals may exhibit an autonomic dysreflexia, significantly reduced bone density below the spinal lesion, joint contractures and/or thermal dysregulation. Persons with SCI can benefit greatly by participation in exercise activities, but those benefits can be enhanced and the relative risks may be reduced with accurate classification of the spinal injury.

Reference:
Pearse DD, Lo TP Jr, Cho KS, Lynch MP, Garg MS, Marcillo AE, Sanchez AR, Cruz Y, Dietrich WD. The Miami Project to Cure Paralysis (with SCI) , University of Miami School of Medicine, Miami, Florida 33101, USA.DPearse@miami project.med.miami.edu

REACTION: Patient with Spinal Cord Injury is a very serious matter to deal with especially that this matter talks about the damaged of central nervous system. Therefore, health care provider should be alert and knowledgeable about the diagnosis of this patient to be able to render a high quality nursing interventions and to avoid errors that worsens the patients’ condition.
Most of the patient who has Spinal Cord Injury are very dependent to others assistance where they need a full support in having their necessities, just like their Activity of Daily Living, and some reason behind this is because they are experiencing paraplegia wherein they may not be able to move their lower extremities and cannot move normally. So, the most focus action is to help the client to promote wellness by doing some appropriate and purposeful exercise movements to help reduce any increased risk factors. Purposeful exercises are being conducted to workout the affected part for the aim to promote circulation and for the muscle to regain strength.
With this article, it helps me to gain some knowledge on what to do and not to do about patient that has Spinal Cord Injury and I’m hoping that in the future I could use this information as an instrument for me to give a better nursing actions to SCI patients’ that I will be encountering.