Category: SCI Blog

Hydrotherapy for Spinal Cord Injury: Understanding the Mechanism

Spinal cord injuries (SCI) are life-altering events that can lead to significant physical, emotional, and psychological challenges. Traditional rehabilitation methods often include physical therapy, occupational therapy, and sometimes surgical interventions. Among these, hydrotherapy, also known as aquatic therapy, has emerged as a highly effective and beneficial treatment modality for individuals with SCI. This article explores how hydrotherapy aids in the recovery process of spinal cord injuries.

What is Hydrotherapy?

Hydrotherapy involves the use of water for pain relief and treatment. It utilizes the physical properties of water, such as buoyancy, resistance, and temperature, to facilitate therapeutic exercises and promote healing. This therapy can be conducted in various settings, including pools, hot tubs, and specialized hydrotherapy tanks.

How Hydrotherapy Aids in SCI Recovery

Buoyancy and Reduced Impact:

Water’s buoyancy helps in making movements easy for individuals with SCI or any other neuro conditions because there is no gravity inside the water. It supports the body, reducing the stress and impact on joints and muscles.

Furthermore, buoyancy is particularly beneficial for individuals with SCI, as it allows them to perform movements and exercises that might be too difficult or painful on land. The buoyant force helps in partially unloading the weight of the patient, making movements easier and reducing the risk of injury during rehabilitation exercises.

Resistance and Muscle Strengthening:

Water provides a natural resistance that helps in muscle strengthening without the need for weights or resistance bands.

This resistance can be adjusted by changing the speed and intensity of movements, allowing for a customizable and progressive exercise regimen. Strengthening the muscles around the injury site is crucial for improving stability and mobility.

Improved Circulation and Cardiovascular Health:

Immersion in water can enhance blood circulation, which is essential for healing and reducing inflammation.

The hydrostatic pressure exerted by water helps in promoting venous return and improving overall cardiovascular health. Enhanced circulation also aids in the delivery of oxygen and nutrients to injured tissues, facilitating the healing process.

Pain Reduction:

The warm temperature of therapeutic pools can soothe muscles and joints, reducing pain and discomfort. The relaxation induced by warm water immersion can also help in reducing muscle spasms and tension, which is often experienced by individuals with SCI.

Improved Range of Motion and Flexibility:

Hydrotherapy can significantly improve the range of motion and flexibility of joints. The water environment allows for a greater range of movement with less discomfort, helping patients to regain mobility. Additionally, regular stretching and movement in water can prevent contractures and improve overall flexibility.

Psychological Benefits:

The calming and soothing properties of water can have significant psychological benefits. Hydrotherapy sessions provide a sense of relaxation and well-being, which is crucial for individuals coping with the emotional and mental stress of SCI. The positive and supportive environment of hydrotherapy can enhance motivation and improve overall mental health.

Implementation of Hydrotherapy in SCI Rehabilitation

Physiotherapist helping SCI patient to do movements.

Hydrotherapy should be administered by trained professionals who can tailor the exercises to the specific needs and abilities of each patient. A typical hydrotherapy session may include:

  1. Warm-Up Exercises: Gentle movements and stretching to prepare the body for more intensive exercises.
  2. Strength and Conditioning: Targeted exercises to strengthen muscles and improve cardiovascular health.
  3. Range of Motion and Flexibility Exercises: Movements designed to enhance joint mobility and flexibility.
  4. Cool-Down and Relaxation: Gentle stretches and relaxation techniques to conclude the session.

Conclusion

Hydrotherapy is a valuable and effective treatment modality for individuals recovering from spinal cord injuries. It is not only beneficial for person with SCI but for all neuro/ortho/geriatric conditions. Its unique properties and benefits make it an ideal complement to traditional rehabilitation methods. By reducing pain, enhancing muscle strength, improving cardiovascular health, and providing psychological support, hydrotherapy plays a crucial role in the holistic recovery of SCI patients. As research continues to support its benefits, hydrotherapy is likely to become an integral part of rehabilitation programs for spinal cord injury recovery.

-By Dr. Virendra Vikram Singh(PT)

We Planned, We Conquered : Ultimate Guide to Visit Vaishno Devi for SCI

Travelling is one of the important aspects of life and after surviving a spinal cord injury the survivors have somewhere in their mind that they won’t be able to explore places again. There is a big stereotype among people with SCI, their family members, and the society that they can’t travel ever again. So, to bust their bubble and create history KSNR came into the picture with our easier said than done plan to take our patients to Vaishno Devi, Katra.
Additionally, KSNR is setting a record by doing so as no group of wheel chair users have ever been there. However, we knew that it’s not going to be that easy but as a rehabilitation center it’s our responsibility to make our patient feel confident and teach them every aspect of life after SCI.

SCI survivors at Vaishno Devi trip.



Planning the trip

As we have decided to go on a hilly area with our wheel chair users so it is very essential for us to plan everything properly before starting our journey. The crucial things which need to be taken care are mentioned below:

Transportation

First and most important thing is to decide how we are going to reach. There are so many ways to reach Vaishno Devi like by road, by train or by air but we have decided to go by bus as we are travelling with our patients thus our main motive was their comfort along with their enjoyment.

So, we booked a bus for the whole trip so that we don’t have to worry about the transportation throughout the trip.

Booking Accommodations

Booking the stay prior to the the journey is equally important because it nearly takes around 12-13 hours to reach Vaishno Devi, Katra from Delhi by road. So, those long sitting hours are definitely going to be tiring for the SCIs as there are many Quadriplegic patients travelling with us as well hence the first thing we need to do after reaching there is to let them take proper rest to avoid any further complexities like UTI, bed sores, etc.

Packing Essentials

Pack all the necessary medications and useful things like comforters , gel cushions etc. which will help to avoid problems like swelling, pain and discomfort. Some individuals with SCI do CIC for urination so for them it is very essential to pack a proper bag with all the necessary items like catheters, gloves, sanitizer, etc.

Visit the Bhavan

It’s the most challenging part of the trip as there are so many obstacles in between like to take Parchi (entry pass) to visit the temple, to complete around 15km trek with people who are not able to stand/walk on their own to reach the bhavan, and most importantly to do the Darshana of Mata and seek blessing in such crowd.
Earlier, we were planning to take our patients to the Bhavan by helicopter but as wheelchairs are not allowed in helicopter we had to drop this plan and then we booked Palkis as our alternate option.

Executing the Plan


After planning our itinerary we are all set to get started with our journey. We started from Delhi around 5-6 PM in the evening and stopped in Jammu in one of the Ashram and afterwards we reached our destination that is Katra in the afternoon. Thereupon our team reached out to Shrine board to inform them about our initiative and seek help from them for VIP Darshan and surprisingly they agreed on the same.

First day in Katra

Once we reached Katra, we let our patients take adequate amount of rest and then in the evening around 7PM we started our trek to the Bhavan along with our patients. As the Yatra route is open 24×7 so one can start their trek whenever they want.

Furthermore, we shifted our patients in the Autorickshaw and reached Bhanganga (where we have to start our trek) thereafter as per the planning SCIs have started the stretch till the Bhavan by Palki and their attendants or family members along with our team have started the trek on foot. We are almost around 30 people so it was almost impossible to reach the Bhavan at same time. So, as soon as our patients reached the Bhavan we started taking them inside the Bhavan one by one. There was around 15-20 stairs which was a big hurdle for us but somehow with the blessings on Mata we reached inside the Bhavan and that’s how our patients did the Darshan and seek the blessings. It took us whole night to complete the Darshan of all the patients and get back to our hotel.


Second day in Katra

On the second day we reached back to hotel around 10 AM in the morning and everyone was so tired so we decided not to do much and let our patients take rest. In the evening the patients explored the Katra market and that’s how we ended our second day.


Third day in Katra

To take some memories from the trip we took our patients to one of the nearby hill station (PATNITOP) and with all those breathtaking views and abundant memories we reached back to Delhi the next morning and completed our trip. It was a wholesome experience for our team as well as our patients and their family members or attendants.

Conclusion

After completing our trip to Maa Vaishno Devi temple successfully I can surely say that it was not at all easy, indeed we faced a lot of difficulties in between but with the proper planning we completed our trip and the memories are going to stay with all of us for our lifetime.
If we can do it anyone can do it. SCI is never the barrier it’s your mind and the society who forces you to think that you cannot do it. So, never let anyone decide for yourself if you want to travel and explore places post SCI just plan it properly and go for it and set examples for others.


A blog by
-Dr. Virendra Vikram Singh ( PT )

The Unwavering Pillar: The Vital Role of Family after Spinal Cord Injury

A spinal cord injury is a life-altering event that can significantly impact not just the individual affected but also their entire support network. Among the key players in this network, family members often stand at the forefront, serving as the unwavering pillars of strength, support, and care. Their role is not just to provide assistance but also to provide emotional, physical and psychological support for the well-being and recovery of the individual.

Family is the strongest pillar after Spinal cord injury.

The Immediate Impact after SCI

The moment an individual experiences an SCI, the entire family is impacted. Shock, disbelief, and emotional upheaval often accompany the initial news. In such tough time, family members become the first helping hands, offering comfort, reassurance, and a sense of stability to the survivor. Not only the comfort and reassurance but they also provide a sense of normalcy amidst chaos. In most of the cases family members are not aware of what is SCI and how to deal with it. So, along with being the helping hand for the survivor they also needs to gather knowledge about SCI and it’s complications.

Emotional Support and Encouragement

Emotional well-being plays a very important role in the recovery journey of SCI. Family members often act as emotional anchors, lending a listening ear, providing empathy, and fostering an environment of positivity. Definitely, the positivity is the reason that SCIs regain their health speedily. Additionally, the family members play a crucial role in preventing feelings of isolation and depression that can often accompany after such a life-altering event.

The consistent encouragement and motivation by these constant pillars contribute significantly to the injured individual’s mental resilience. Their unwavering belief in the person’s ability to adapt and overcome challenges becomes a driving force during the recovery process.

Physical Care and Assistance

Other than emotional support, family members also helps SCIs with proper physical assistance. They becomes caregiver for the survivors immediately after their injury. After SCI the survivors lose their mobility depending on their level of injury and therefore require significant physical support. The practical aspects of caregiving post-SCI are multifaceted and demanding. From aiding with daily activities to ensuring accessibility within the home, family members often take on the role of primary caregivers. Tasks like mobility assistance, personal care, helping in daily activities and managing medical needs become integral parts of their daily routine.

Adaptation and Environmental Adjustments

The family’s role extends beyond physical care; they are instrumental in creating an inclusive and supportive environment. Adapting the living space, altering routines, and making adjustments from installing ramps and handrails to rearranging furniture for easier mobility, these adaptations are essential for the injured person’s comfort and independence. This inclusivity not only aids the individual’s physical well-being but also fosters a sense of belonging and normalcy, crucial for mental health.

Learning and support

Families often need to undergo a learning process post-SCI, understanding the intricacies of the injury and how to support the individual in the best possible way. As, the impact and severity of the injury is different for different individuals. Also post-SCI the individuals faces a lot of challenges like immobility, bladder & bowel dysfunction and many more.

Moreover, family members may need to advocate for the injured person, navigating healthcare systems, rehabilitation programs. Their dedication and advocacy often ensure that the individual receives the best possible care and resources for their recovery.

Conclusion

In the journey of recovery after a spinal cord injury, the role of family stands unparalleled. Their unwavering support, dedication, and sacrifices contribute immensely to the individual’s rehabilitation and quality of life. Moreover, the demanding nature of caregiving can be emotionally and physically draining. Thus, respite care and self-care are vital for caregivers as well.

– By Dr. Virendra Vikram Sigh(Physiotherapist)

The Vital Role of Nutrition In SCI

Different forms of nutrition in food

SCI can have a profound impact on an individual’s life; it does not only affect the mobility but also overall health and well-being. There are so many issues and secondary complications that come with SCI such as loss of control over bladder & bowel, neurogenic bladder and bowel, urinary tract infection, chronic constipation, weight management, pressure sores and a lot more. To tackle with these complications along with rehabilitation, maintaining a good nutrition is also crucial. Nutrition plays a very important role in supporting the recovery and long-term health in SCI patients.

In this blog, we will explore why nutrition is essential for individuals with SCI and provide tips to optimize dietary habits.

Importance of Nutrition In SCI Patients:

After an SCI, the body’s nutritional needs may change, and proper nutrition becomes even more vital. Here are some key considerations and the crucial role of nutrition after a spinal cord injury:

12 main vitamins


1. Adequate Calories and Protein Intake

SCI often leads to changes in metabolism, muscle breakdown, tissue damage and a decrease in body mass. Consuming enough calories through extra protein rather then carbohydrates is essential to support the body’s healing process, maintain muscle mass, and prevent complications such as pressure sores and infections.

Protein-rich foods like pulses, oats, soya bean, eggs, lean meats, fish, and dairy products should be included in the diet.

2. Adequate Fiber Intake

After SCI depending upon the level of injury, many people loose bladder and bowel sensation. Digestion of food and movement of stool towards colon and rectum also slows down resulting in issues such as constipation, incontinence causing bowel accidents and sometimes diarrhea too.

Consuming an adequate amount of dietary fiber, found in fruits, green vegetables, cucumber, carrot, whole grains, and pulses can help soften the stool and hence promote regular bowel movements and prevent constipation.

3. Hydration

Staying hydrated is important for everyone, but it is particularly crucial for individuals with SCI. Proper hydration keeps healthy skin, helps prevent urinary tract infections, supports digestion, aids in regulating body temperature, and promotes overall health. Water, coconut water, and low-sugar beverages should be consumed throughout the day.

In addition, it is also very important to give calculated amount of liquid as suggested by the medical advisor if the person is doing CIC for urination to prevent leakage.

4. Calcium and Vitamin D

Individuals with SCI may have a higher risk of osteoporosis due to inactivity and decreased weight-bearing activities. Adequate calcium and vitamin D intake is important to maintain bone health. Dairy products, green leafy veggies, nuts, and supplements may be recommended to ensure sufficient calcium and vitamin D levels. Vitamin D is mandatory with calcium supplements for better absorption.

5. Antioxidants and Anti-inflammatory Foods

 SCI may lead to an increase in oxidative stress and inflammation in the body. Consuming antioxidant-rich foods, such as berries, leafy greens, nuts, and seeds, can help counteract oxidative stress. Foods with anti-inflammatory properties, such as fatty fish, turmeric, ginger, and olive oil, may also be beneficial.

6. Vitamin and Mineral

Individuals with SCI may have a higher risk of vitamin B12 deficiency due to changes in absorption. Vitamin B12 is essential for nerve function and blood cell production. Including sources of vitamin B12, such as meat, fish, dairy, and fortified foods, or taking supplements if needed, is important.

Furthermore, along with Vitamin B12 person with SCI may also have low phosphorus and sodium level. Mostly quadriplegics have low Blood Pressure causing lethargy and restlessness, so It is advisable to increase salt intake unless they have high blood pressure issues.

Additionally, Vitamin C and zinc intake is also essential as it promote skin health. Vitamin C helps the body absorb iron more effectively and helps fight infections. It also aids in better absorption of protein. Good sources of vitamin C include lemon, orange juice, orange, kiwi, and broccoli. Sources of zinc include lean meat, liver, eggs, legumes, seafood, and milk. Dry fruits not only provide fiber, protein but many essential minerals.

7. Weight Management

Healthy eating can help lower your risk for becoming overweight or obese and for developing other medical complications, such as constipation, diarrhea, diabetes, infections, and limit your muscle loss.

Food choices determine the amount of calories you consume. Extra calories lead to weight gain and affect your daily activities, such as strength, stamina, and transferring. So, it is important to choose foods that are rich in nutrients while staying within your calorie limits. It is advisable to eat more seasonal fruits mainly water melon, mass melon, papaya and raw vegetables fruits, raw vegetables, salad helps in salad of cucumber, radish, turnip, beat root etc. This helps in filling your belly on one hand and very low calories on the other.

The Vital role of Nutrition In SCI: Key Points

Maintaining proper diet and taking enough amount of nutrition can help boost your recovery faster and also help in fighting with other secondary complications.  Here are some key points mentioned below to maintain proper diet:

  • Try to take as much of green leafy vegetables and seasonal fruits as much as possible as they are rich source of nutrients, high in fiber which helps in bowel management and also they are low caloric.
  • Try to take nuts or dry fruits (except cashew because it is high in calorie)  as evening snacks and avoid packaged food, cold drinks, too much of white sugar, sweets to maintain proper weight.
  • Increase vitamin C intake as it helps to prevent Urinary tract infections and any other infections. Also better absorption of iron and protein.
  • It is advisable to consume adequate amount of Salad.
  • Being hydrated is important for every being but comparatively it is more important for person with SCI as it can cause UTI, constipation, and a lot of other health issues.

Key is balanced diet, thrice a day and in moderate quantity. Snacks between two meals should be fresh fruits and dry fruits, A healthy diet will improve your health, but you can increase your health benefits by combining a healthy diet with other lifestyle changes, such as including physical activities, limiting alcohol use and smoking, as well as maintaining good mental health.

–By Dr. Virendra Vikram Singh (PT)

 

Transformative Power of Sports: Changing the Lives of SCIs

After Spinal cord injury an individual’s life is significantly altered, making it challenging for them to adjust to the new changes. This can have a profound impact on their mental health, leading to feelings of difficulty adapting and a sense of loss of control. However, there are several positive actions that can be taken to foster a healthy mindset and move forward with life. One of the most effective ways to promote mental well-being is through participation in sports.

International sports person Sakshi Kasana throwing shotput.

Sports can bring sense of positivity and purpose back into an individual’s life, helping them to adapt new circumstances. Additionally, it can provide a source of income for individuals with SCIs, which can be a valuable tool in their recovery. Apart from this participation in sports holds immense transformative potential in enhancing the lives of individuals with SCISs. Here’s how:

  • Physical Rehabilitation and Health Benefits
  • Improved mobility and functionality
  • Reduced secondary health issues
  • Social connection and support
  • Boost in confidence and self-esteem
  • Advocacy and awareness

Numerous Benefits of Sports

1. Physical Benefits

Engaging in adapted sports can significantly enhance the physical fitness of individuals with SCIs, leading to improved strength, endurance, and overall fitness levels. These activities also contribute in better health and vitality.

Moreover, it can improve mobility and functionality by enhancing range of motion, balance, and coordination, resulting in improved mobility and a sense of independence.

Additionally, it can help in minimizing the secondary health complications such as osteoporosis or cardiovascular problems.

2. Psychological and Emotional Benefits


Participating in sports can have a positive impact on psychological well-being and emotional resilience of an individual.

Furthermore, it can boost confidence and self-esteem, leading to a sense of positivity and accomplishment.

Additionally, sports can help reduce stress, anxiety, and depression, which is a significant concern for individuals with SCIs.

3. Improved Social Connection


Involvement in sports programs can also create opportunities for social interaction, friendship, and a sense of belonging within society.

Furthermore, this social connection and support can be particularly important for individuals with SCIs, who may face social isolation and stigma.

4.Advocacy and Awareness


The involvement of SCIs in sports can serve as a platform to advocate for disability rights and accessibility.

Also, by showcasing the capabilities and potential of individuals with disabilities, adapted sports can also help in breaking down stereotypes and promote a more inclusive society.

Adaptive Sports for disabled bodies

Like abled bodies people with disability can also play any sort of games. Some of the games are mentioned below:

  • Archery
  • Athletics
  • Track and field
  • Boccia
  • Shooting
  • Wheelchair Basketball
  • Wheelchair cricket
  • Wheelchair rugby
  • Powerlifting
  • swimming

Classification determines who is eligible to compete in a para sport and it groups the eligible athletes in sport classes according to their activity limitation in a certain sport.

Transformative Power of Sports: Key points

Adapted sports play a crucial role in transforming the lives of individuals with SCI by not only improving their physical health but also nurturing their mental and emotional well-being. These sports create a pathway to empowerment, independence, and a fulfilling life beyond the confines of their injury.

-By Dr. Virendra Vikram Singh(PT)


Spasticity : Causes, Challenges, Benefits and Management

Following a spinal cord injury, Spasticity is a common complication that can impact daily life and overall function. In this article we will discuss spasticity, its underlying causes, challenges and effective strategies for managing and overcoming the condition.

Physiotherapist helping individual with rehab exercises to overcome spasticity

What is Spasticity?

Spasticity refers to the increased muscle tone and involuntary muscle contractions that often accompany spinal cord injury. It is a disruption in muscle movement pattern which is caused due to contraction of many muscles at once (sometimes called co-contraction). Spasticity can also be in the form of jerky muscle movements (spasms) or stiffness.

It is very common in individuals with SCI and gradually depends on the level and impact of injury. Individuals with cervical injury are more likely to have spasticity than individuals with lower level injuries. Spasticity can vary greatly in how it affects someone — it may be as mild as the feeling of tightness of your muscles or may be so severe that it causes painful, uncontrollable stiffness and spasms of your extremities.

Causes of Spasticity

Spinal cord works as a pathway which helps brain to communicate with other parts of the body. Spinal cord helps to send sensory information such as hot , cold, pain, movement, etc. from body to brain and vice-versa. Once the brain receives these sensory signals, it processes the information, and then sends the appropriate signals back down the spinal cord to tell the muscles how to respond.

However, when the spinal cord is injured the communication gets disrupted and due to which sensory information is unable to reach the brain. The lack of proper communication contributes to the hyperexcitability of spinal reflexes, which can results in muscle spasms.

Changes in neurotransmitter levels, particularly a decrease in inhibitory signals, play a role in the development of spasticity. This imbalance contributes to excessive muscle contractions.

The loss of supraspinal (above the spinal cord) control over reflexes results in unregulated muscle activity. The absence of inhibitory signals from the brain contributes to heightened muscle tone.

Challenges and Benefits

There are a lot of challenges or difficulties faces by individuals due to spasticity.

  • Spasticity can significantly impact mobility, making it challenging for individuals with SCI to move freely.
  • Prolonged stiffness or spasticity can limit the range of motion in your joints. This may lead to joint contractures, which can cause structural changes in the affected joints.
  • Sometimes the spasticity can be so severe that it can cause unbearable pain to the individuals.
  • Spasticity can make movement so hard which complicate tasks like dressing, grooming, and bathing, making independent self-care more challenging.
  • Repeated muscle spasms at night can cause difficulty in sleeping which may impact fatigue and mental health.
  • Severe spasm can make individuals fall out of the wheelchair, if not taken care properly.
  • Spasms in bladder can lead to leakage of urine which may results in UTI.

However, there are so many many difficulties faced by people with SCI due to spasticity but it has some benefits as well.

  • The muscle contractions associated with spasticity can enhance blood circulation, reducing the chances of vascular complications. Improved blood flow contributes to overall cardiovascular health.
  • Regular muscle contractions can assist in joint flexibility and reduce the risk of joint immobility.
  • Stiffness causes fingers to bend which helps in holding things and grip objects.
  • Spasticity can provide a degree of postural support, aiding individuals with SCI in maintaining certain positions.
  • It minimizes the risk of pressure sores associated with prolonged immobility.

Strategies for Overcoming Spasticity

There are various ways to overcome spasticity. Though there’s no cure for spasticity, these treatments can help alleviate symptoms and improve quality of life.

1. Physical therapy/ Rehab exercises

Engaging in targeted physical exercises can help manage spasticity. Rehab exercises like weight bearing, prone lying (lying on stomach) help stimulate the nervous system and activate neuroplasticity. Exercising consistently also helps reduce the excitability of hyperactive muscles.

Therapists can design personalized routines to stretch and strengthen muscles, improving overall mobility. It can also help in reducing muscle spasms and getting range of motion over the time.

2. Medications

Muscle spasms can cause severe pain and can be very discomforting at times. There are some medicines which healthcare professionals can prescribe to overcome the pain and discomfort. However, it is advisable to take these medications only when it’s needed and not on regular basis.

For severe spasticity cases, baclofen pumps are used for delivering muscle relaxant directly to the spinal fluid. This targeted approach can effectively reduce spasticity levels.

3. Orthotic Devices

Implementing orthotic devices, such as braces or splints, can aid in supporting joints and controlling spasticity. These devices helps to improve mobility and enhance overall comfort.

Additionally, we can prevent deformities caused by spasticity by using the orthotic devices which helps to maintain range of motion of an individual.

4. Botox Injection and Surgery


Botulinum toxin injections, commonly known as Botox, are a medical treatment option for managing spasticity, particularly in conditions like stroke and spinal cord injury. The injections are injected directly into specific muscles to get temporary relief from spasticity.

Surgical treatment is also a type of treatment for spasticity. Although, we should consider surgical treatments for spasticity only in cases where conservative approaches, such as physical therapy and medications, have not provided sufficient relief.

Additionally, It’s important to note that surgical interventions and Botox treatment for spasticity are typically reserved for cases where other treatments have not been effective, and the decision to undergo surgery should be carefully considered after consulting with consult with a multidisciplinary team of healthcare professionals. The choice of surgery depends on factors such as the underlying cause of spasticity, the severity of symptoms, and the individual’s overall health.

Travel Tips Post SCI

This blog will help SCIs to travel as many places as they want without any hassle.

Travel after a Spinal Cord Injury might seem scary, but it’s entirely possible with the right preparation and mindset. Exploring new places and making memories shouldn’t be limited by spinal cord injury. With few essential tips and a bit of planning, traveling can be enjoyable and fulfilling for individuals with SCI. In this blog we will discuss about the tips which make travelling easier for individuals with SCI.

Pre-Travel Preparation

Before starting your journey, it is crucial to ensure that every aspect of your travel is on point to guarantee a smooth and hassle-free experience. First and foremost, consult with your healthcare provider or physiotherapist for their advice. They can help you identify any potential risks or challenges and provide recommendations for accommodations and transportation that cater to your specific needs.

While searching for accommodations, book properties that are wheelchair accessible and equipped with amenities suitable for individuals with disabilities. Many websites and apps, such as Airbnb and Booking.com, offer filters to help you find accessible properties.

In addition, ensure that your chosen mode of transportation—whether it’s by air, train, or bus—can accommodate your needs. Many airlines and transportation companies provide special services for travelers with disabilities; contact them in advance to make necessary arrangements and arrive airport, railway station or bus stand as early as possible to avoid any further inconvenience.

While travelling in flight request wheelchair assistance before-hand, this can help you navigate through the airport, including security checkpoints and boarding areas. Request this service when booking your flight or contact the airline in advance to make arrangements.

Packing Essentials

Medical Supplies

Carry an ample supply of medications, catheters, medical documents, and any essential medical equipment. It’s advisable to carry extra supplies in case of unexpected delays.

Mobility Aids

Bring your mobility aids—wheelchair, walker, stick—along with any spare parts or tools needed for maintenance. Consider lightweight and portable options for convenience during travel.

Comfort Items

Pack items that provide comfort during the journey, such as pillows, blankets, or specific adaptive seating cushions that help maintain posture and prevent pressure sores. It is advisable to wear stockings while travelling. Pack clothes according to your destination and try to avoid tight clothes as it may cause inconvenience.

Assistance and Communication

Do not hesitate to ask for assistance or help whenever needed. There are many people who are willing to help, whether it’s airport staff, hotel employees, or fellow travelers. While traveling, it is reccomendable to be adaptable and patient throughout the trip as things might not always go as planned. It’s important to embrace the unpredictability of the journey and be prepared for last-minute changes.

Ultimately, enjoy the experience and cherish the unforgettable moments and breathtaking views. By doing so, you’ll be able to fully appreciate the beauty of the world around you and create lasting memories that will enrich your life.

Key Points : Travel tips post SCI

Traveling after a spinal cord injury may require additional planning and considerations, but it should never hinder your sense of adventure and exploration. With the right preparation, accessible destinations, and a positive mindset, you can embark on incredible journeys and create lasting memories.

Remember to plan ahead, research your destinations, and communicate your needs effectively. Take advantage of resources and support available for travelers with disabilities, such as travel forums, disability travel blogs, and local accessibility organizations.

Embrace the freedom of travel and let your post-SCI adventures inspire and empower others. Your experiences can help break down barriers and create a more inclusive travel environment for individuals with disabilities. So pack your bags, and get ready to embark on a journey of a lifetime!

By Virendra Vikram Singh (PT)

Understanding Different Types & Levels of Spinal Cord Injury

Spinal Cord Injury- types & levels

Spinal cord injury are life-altering and can vary in severity. From complete loss of motor and sensory function to partial impairment, each level of injury presents unique challenges to patients. We will explore how these injuries affect mobility, strength, and bodily functions.

By understanding the different levels of SCI, you will gain a clearer picture of the physical and emotional journey faced by those affected. Nevertheless, with this knowledge, you can better support yourself, a loved one, or your patients in coping with the challenges and adjustments that come with a spinal cord injury.

Types and Classifications of SCI

Spinal cord injuries can be classified into two main categories: complete and incomplete. A complete SCI refers to the loss of all motor and sensory function below the level of injury. On the other hand, an incomplete SCI means that there is some degree of motor or sensory function below the level of injury.

Within these categories, there are different levels of spinal cord injury based on where the injury occurs along the spinal cord. The spinal cord is divided into four regions: cervical, thoracic, lumbar, and sacral. Each region controls different parts of the body, and an injury at a specific level can result in varying degrees of impairment.

Understanding the Levels of Spinal Cord Injury

Cervical Spinal Cord Injury

Cervical spinal cord injuries occur in the neck region and can have serious consequences. Higher-level injuries in the cervical region can result in quadriplegia, where all four limbs and the trunk are affected which leads to a loss of function in the arms, hands, and legs, making daily activities challenging. This can impact mobility, balance, and coordination.

Thoracic/Dorsal Spinal Cord Injury

Thoracic spinal cord injuries occur in the upper back region and can lead to high-level paraplegia. The severity of impairment will depend on the specific level of injury. Individuals with thoracic spinal cord injuries may experience difficulty with trunk control, balance, and bowel and bladder function.

Lumbar Spinal Cord Injury

Lumbar spinal cord injuries occur in the lower back region and typically result in paraplegia. The extent of impairment will vary based on the level of injury. Furthermore, Individuals with lumbar spinal cord injuries may face challenges with walking, standing, lower limb function, and bowel and bladder control. In addition, earlier the trunk control is also impacted but with the proper rehabilitation it gets better .

Sacral Spinal Cord Injury

Sacral spinal cord injuries occur in the lowest region of the spine and can lead to varying degrees of impairment. These injuries can affect bowel, bladder, and sexual function, as well as lower limb strength and mobility. Unlike Cervical or Dorsal level, Sacral level doesn’t impact trunk control.

Complications and Long-term Effects of Spinal Cord Injury

Spinal cord injuries can have a range of complications and long-term effects. Some common complications include pressure sores, urinary tract infections, respiratory problems, muscle atrophy, and osteoporosis. Additionally, individuals with spinal cord injuries may also experience psychological effects, such as depression and anxiety.

Moreover, long-term effects can include chronic pain, spasticity, loss of muscle tone, and decreased cardiovascular health. It’s crucial for healthcare professionals to address these complications and provide appropriate interventions to enhance the quality of life for patients with spinal cord injuries.

Conclusion

Understanding the different levels of SCI is essential for healthcare professionals, patients, and individuals seeking knowledge about this topic. By gaining insights into the types, classifications, and levels of SCI, we can better comprehend the challenges faced by those affected. Moreover, being aware of the available treatment options and rehabilitation techniques allows for better support and care for individuals with spinal cord injuries. Let us empower ourselves with knowledge and empathy as we navigate the complexities of SCI.

Bowel Dysfunction and Management In SCI

For individuals living with a spinal cord injury (SCI), maintaining proper bowel function
is a crucial aspect of daily life. An SCI can disrupt the natural neurological control of
the bowel and bladder, leading to challenges like constipation and incontinence. However, with
tailored strategies and support, individuals with SCIs can regain control and enhance
their overall quality of life.


Understanding Bowel Dysfunction in SCI

A spinal cord injury alters the communication between the brain and the nerves
below the level of the injury. This disruption often results in neurogenic bowel
dysfunction, where the muscles and nerves responsible for bowel function no longer
operate as they should. This can give rise to a range of bowel management issues that
significantly impact an individual’s daily life.


Common Bowel Dysfunction Issues in SCI


Constipation: One of the most prevalent problems in neurogenic bowel dysfunction is
constipation. The slowed movement of stool through the colon due to weakened or
paralyzed muscles can lead to infrequent, hard-to-pass bowel movements.
Incontinence: Some individuals with SCI may experience loss of sensation and muscle
control in the rectal area, resulting in involuntary bowel movements. This can be
emotionally distressing and may require extra care and management.
Impaction: In severe cases, stool can become impacted in the rectum, causing
discomfort, pain, and further complications. This condition may necessitate more
intensive interventions to resolve.


Risk Factors and Severity

The extent of bowel dysfunction in SCI can vary widely depending on factors such as
the level and severity of the injury, as well as the individual’s overall health. Those with injuries higher up on the spinal cord (closer to the head) typically experience more pronounced bowel dysfunction, as the nerves controlling bowel function originate higher up in the spinal cord.


Management and Treatment

Diet and Hydration: A balanced diet rich in fiber, along with sufficient water intake, is
crucial in managing bowel dysfunction. Fiber helps regulate bowel movements, while
staying hydrated softens stool, making it easier to pass.
Scheduled Bowel Care: Establishing a regular bowel care routine can help train the
body to have predictable bowel movements. This often involves techniques like digital
stimulation, suppositories, or enemas.
Medications and Supplements: Depending on the specific needs of the individual,
healthcare providers may recommend medications or supplements to regulate bowel
function.
Adaptive Equipment: Specialized tools and equipment, like bidets or assistive devices,
can assist with bowel management and improve comfort and hygiene.
Physical Activity: Engaging in regular, safe physical activity within one’s abilities can
help maintain overall health and support bowel regularity.
Consultation with Healthcare Providers: Working closely with healthcare
professionals, including specialists in SCI care and dietitians, is essential. They can
provide personalized guidance and address any complications or concerns.

Bowel dysfunction is a common and significant aspect of life for individuals with SCI.
However, with proper care, management, and support, it’s possible to mitigate its
impact and lead a fulfilling life.

By Virendra Vikram Singh(PT)

Bed Sores Causes and Prevention

Spinal cord injury patients are at a higher risk for developing bed sores, also known as pressure ulcers or pressure sores, due to decreased mobility, sensation, and blood flow. The main cause of bed sores in SCI patients is prolonged pressure on the skin and soft tissues, which leads to tissue damage and skin breakdown. Here are some specific causes of bed sores in SCI patients:

Immobility: Individuals with SCI often have limited mobility, which can cause pressure on specific areas of the body and increase the risk of developing bed sores. This is especially true for those who are unable to shift their weight or change positions independently.

Lack of sensation: SCI patients may have decreased or absent sensation in certain areas of the body, making it difficult to detect early signs of skin breakdown. This can lead to delayed treatment and increased risk of developing bed sores.

Incontinence: SCI patients may experience bowel or bladder incontinence, which can lead to skin irritation, maceration, and increased risk of developing bed sores.

Shearing forces: SCI patients who are repositioned or moved frequently may experience shearing forces on the skin, which can lead to tissue damage and increased risk of developing bed sores.

Poor nutrition: SCI patients may have difficulty maintaining a healthy diet, which can lead to malnutrition and weakened skin, increasing the risk of developing bed sores.

Certain medical conditions: SCI patients with certain medical conditions, such as diabetes or circulatory problems, may be at higher risk of developing bed sores due to impaired blood flow to the skin and soft tissues.

Stages of Bed sores

In individuals with SCI, pressure sores often occur in areas where there is prolonged pressure, such as the sacrum, buttocks, and heels. It is important to catch pressure sores in the early stages to prevent progression to more severe stages. There are four stages of pressure sores, each with increasing severity:

Stage 1: This is the mildest stage of pressure sores, where the skin may appear red, but it is not broken. The affected area may feel warm or spongy to the touch, and the person may experience itching or pain.

Stage 2: In this stage, the skin is broken and there may be a shallow open wound or blister. The area around the sore may be red and inflamed, and there may be some drainage or pus.

Stage 3: At this stage, the sore has extended through the skin and into the underlying tissues, such as muscle or fat. The wound may be deeper and appear as a crater-like hole, and there may be signs of infection such as redness, warmth, and pus.

Stage 4: This is the most severe stage of pressure sores, where the wound has become very deep, extending into the muscle, bone, or joint. There may be necrosis or dead tissue, and the wound may have a foul odor. Infection is very likely at this stage, and there is a risk of complications such as sepsis.

Prevention of Bed Sores

Preventing bed sores is very important for individuals with spinal cord injury, as it has a great impact on the patient’s rehabilitation and also they are painful and may increase the risk of infection, which can be especially dangerous for individuals with spinal cord injuries.Here are some specific prevention strategies for SCI patients:

Regular repositioning: SCI patients should be repositioned at least every two hours to relieve pressure on the skin. This can be done manually by a caregiver or with the help of specialized equipment, such as a tilt table or turning frame.

Pressure relief devices: There are various pressure relief devices that can be used to help prevent bed sores in SCI patients, such as cushions, mattresses, and overlays. These devices work by distributing pressure over a larger surface area and reducing the risk of skin breakdown.

Skin care: Keeping the skin clean and dry is important for preventing bed sores. SCI patients should be washed with mild soap and water, and moisturizers can be used to keep the skin hydrated. Any areas of redness or irritation should be addressed promptly.

Nutrition: A healthy diet with adequate protein intake is important for promoting skin health and preventing bed sores. SCI patients may also benefit from nutritional supplements, such as vitamins and minerals.

Exercise: Regular exercise can help improve circulation and prevent bed sores. SCI patients should work with a physical therapist to develop an exercise program that is safe and appropriate for their level of injury.

Manage moisture: Excessive moisture on the skin can increase the risk of developing bed sores. Incontinence should be managed promptly, and moisture-wicking fabrics can be used to keep the skin dry.

Regular skin checks: SCI patients and caregivers should regularly check the skin for any signs of redness, irritation, or pressure sores. Early detection and treatment can prevent bed sores from developing or worsening.

So, it is very important to seek medical advice as soon as possible to prevent progression of bed sores to more severe stages, which can result in complications such as infection and sepsis.

By Virendra Vikram Singh(PT)