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.

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)

Bed Sore and It’s Impact On SCIs

Bed sores, also known as pressure ulcers or pressure sores, are a common complication of spinal cord injury. They occur when a person is immobilized or confined to bed or wheelchair for a longer period of time, leading to pressure and friction on the skin. In SCI patients, bed sores often occurs in areas of the body that are subject to more pressure such as the hips, elbows, tailbone and heels. These sores can range in severity from mild redness and irritation to deep wounds that expose muscle and bone.

These sores can have a significant impact on the patients as well as on their rehabilitation process. Here are some ways bed sores can affect SCI patients:

Pain and Discomfort: Bed sores can be really painful and uncomfortable, making it difficult for the patients to participate in their daily as well as rehabilitation activities such as physical therapy and mobility exercises.

Delayed healing: Bed sore can take a long time to heal, which can delay a person’s rehabilitation progress and hence they may need to spend some extra time in their rehabilitation center in order to become independent, which can be emotionally and financially draining for them as well as their family.

Increased risk of infection: bed sores are open wounds and hence they can become infected, which may leads to sepsis and sometimes the infection get may worsen and reached to the bones which will be a life threating condition for SCIs.And if not treated at the right time this can lead to prolong hospitalization.

Limited mobility: In severe cases, bed sores can restrict a patient’s mobility, making it difficult to sit, stand, or move. This can make it challenging for patients to participate in rehabilitation activities and hinder their overall recovery.

Emotional Impact: Bed sores can be emotionally distressing for SCI patients, affecting their self-esteem and confidence. It can also be frustrating for patients to feel like their progress is being hindered by a preventable complication.

By Virendra Vikram Singh(PT)

Bladder Management After SCI

After spinal cord injury due to severe nerves damage the bladder and bowel movement got impacted. Before SCI a message sent from the brain travelling along the spinal cord and sacral nerves to allow the bladder to get empty. But after spinal cord injury sometimes the communication between the brain and the nerves in the spinal cord that control bladder and bowel function got interrupted. This can cause bladder and bowel dysfunction known as neurogenic bladder or neurogenic bowel.

So some of the ways of Bladder management after SCI are mentioned below:

Intermittent Catheterization

It is one of the ways to empty the bladder without keeping the catheter in the bladder all the time. In this a catheter is inserted into the bladder to drain out the urine from the bladder. The urine is drained out from the other end of the catheter. Remove the catheter once done and you are good to go for your normal activities. It is usually done 4-6 times a day to avoid leakage. It is advised to drain out the urine after every four hours so that catheterization volumes less than 500 ml. So you may have to catheterize often depending on how much you drink.

Indwelling Catheterization

Indwelling catheterization uses a catheter and a urine collection bag that stays in place all the time. The catheter has a balloon at the tip of the catheter which sits in your bladder. Once the catheter is in your bladder, the balloon can be inflated to keep the catheter from falling out or deflating when it’s time to change the catheter.

There are two types of indwelling catheters: urethral catheters and suprapubic catheters. Most urethral catheters that are kept in place by filling up a balloon. People might call your indwelling catheter a Foley’s catheter.

Reflex Voiding 

This technique works best for male patients but it can be used in female patients. For males, try to train the bladder to urinate just by reflex so when the bladder reaches a certain set point it causes the bladder muscles to contract and squeezes the urine out. For male patients, the urine can be captured by applying a condom to the penis which is then collected to a drainage bag. This is a method that has a less chance of developing infection and it is sometimes less labor intensive for the patient and caregiver because care is just application of a new condom every day, the condom is removed and the penis is cleaned and allow to dry for about 20 minutes before the next condom is applied then it is connected to the leg bag or bed  bag and the only care during the day is that the bags  have to be emptied when they get to a certain level of fullness.

Urinary Tract Infections

But proper bladder management is a must for a SCI patient because as we discussed above spinal cord injury can affect the ability to control the bladder, leading to an increased risk of urinary tract infections (UTIs). UTIs are common in people with SCI, and can cause many symptoms such as frequent urination, pain or discomfort during urination, and fever. These symptoms can mild or severe depending upon the impact of infection.

In individuals with SCI, UTIs can occur more frequently and may lead to more serious complications such as kidney damage and sepsis if it is not treated well.in people with SCI, the infection can be more serious and harder to treat than in general population. This is because the spinal cord injury can interfere with the body’s immune system, making it harder to fight infections.

Preventing UTIs in people with spinal cord injury involves maintaining good hygiene practices, such as washing the genital area daily and cleaning the catheter insertion site regularly. It is also important to ensure that catheters are changed regularly and that the bladder is fully emptied during each catheterization.

If a UTI is suspected, it is important to seek medical attention promptly. Treatment typically involves antibiotics to clear the infection, as well as measures to manage any associated symptoms. In severe cases, hospitalization may be necessary.

By Virendra Vikram Singh(PT)

Neuroplasticity “The best way to boost SCI recovery”

For a very long period of time it was believed that spinal cord injury cannot be recovered but it was proved wrong. By adapting neuroplasticity it can be recovered depending upon the completeness of injury.

So let’s understand what is neuroplasticity first, neuroplasticity is how spinal cord rewires itself. It allows for functions affected by spinal cord injury to be relearned and recovered. To understand neuroplasticity better, it’s essential to understand how spinal cord injury affects the body. Spinal cord serves a pathway between brain and body to communicate. After the injury the communication disrupts and hence results in motor and sensory loss.

Spinal cord injury can be complete or incomplete and neuroplasticity can be complied based on the completeness of injury. Complete injury occurs when the spinal cord is completely damaged or transected. This means the pathways are completely disrupted and the body and the brain are not at all able to communicate with each other, resulting in the complete loss of sensory and motor depending upon the level of injury.

Incomplete injury describes when the spinal cord is partially damaged or transected. This means the pathways are not fully disrupted which leaves spared neural pathways and hence the communication between brain and body are not completely lost. So the individuals have some motor control and sensory below their level of injury.

Spared neural pathways are an essential component of spinal cord injury recovery because damaged neurons in the spinal cord are not capable of regeneration. Instead, only healthy, spared neural pathways in the spinal cord can utilize neuroplasticity to make adaptive changes. As a result, only individuals with incomplete SCI have the ability to utilize neuroplasticity to recover functions affected by injury. 

How to Engage Neuroplasticity

Neuroplasticity allows the brain and spinal cord to adapt and recover functions affected by injury. Where there is damage in spinal cord, neuroplasticity is necessary to rewire new connection around the damage. One needs to strengthen the connections that survive the injury by promoting neuroplasticity and circuit regeneration.

Basically there are three essential; components for promoting neuroplasticity after SCI. we will discuss all three of them one by one.

Specificity

Training specifically is crucial for promoting neuroplasticity after spinal cord injury because each movement you make is attributed to a specific set of neural pathways. Every time you practice a specific movement, it reinforces demand for that function. The more specific you are with your training, the better the spinal cord gets at perceiving a demand for those functions and rewires itself.

Repetition

High repetitions are also one of the major components of promoting plasticity. Repetitive practice is how you will get your life back after SCI and recover the fastest way possible. Every time you repeat a movement, you’re strengthening its neural pathways. The stronger the neural pathway becomes the easier and more natural the movement becomes.

Intensity

Lastly, the intensity of your training helps determine how quickly you recover. Intensity consists of how much resistance, speed, repetitions, time, and effort is put into your recovery.

So this is how the neuroplasticity works and help patients to recover if possible.

By Dr. Virendra Vikram Singh(PT)

Mental Health in Spinal Cord Injury

It is a big-big challenge for people to start their life again after a Spinal cord injury because shifting from an able to a completely or partially disable person is a life-long process and it takes a lot of courage as well as adjustments. A person’s life and lifestyle is completely changed after SCI. Their independency, their worth everything is on stake andwhichgives rise to negative thoughts and further causes psychologicaldistress.

Depression and anxiety are very normal reactions to the physical changes as well as to the day-to-day consequences of the injury and subsequent disability. Sometimes the case may worsen and people need to consult psychiatrist and start medications as well. Moreover, the mental health becomes a major issue when it starts limiting the person from taking part in their physical therapy and moving on with life. Without proper management this can hinder one’s ability to pursue rehabilitation and negatively impact recovery outcomes.

The factors that affect the mental health are mentioned below.

Chronic Pain

Chronic pain is basically the pain that lasts 3 months or longer and hence causes changes in the spinal cord injury and how the brain perceives the pain. Chronic pain can affect the entire central nervous system resulting in severe pain that is hard to treat. It can be debilitating and problematic that is often accompanied by depression and psychological issues.

There is not always a known cause of chronic pain, whereas other times the pain is lingering symptom of an injury or accident.

Impaired Mobility

It is one of the major causes of depression among SCI patients. Impaired mobility is a state in which the individual experiences the limitation of physical movement. After the spinal cord injury due to this impaired mobility people are unable or may not be able to perform or participate in their favorite activities, atleast in initial phases and this leads to negativity in the thoughts of the individual.

Medications

There are so many complications related to SCI which includes chronic pain, respiratory infection, urine infection (UTI), spasticity, depression and so on.  So to conquer these complications and get going with the rehabilitation in a proper way SCI patients are advised to start medications. These strong medicines affect the function of the brain very badly.

Lack of Independence

SCI usually causes severe locomotion disability due to paralysis of muscles. Depending of the level and impact of injury a person with SCI can completely be independent or need full assistance in their daily living activities and rehabilitation.

Other consequences of SCI, such as sensory, spasticity, chronic pain, neurogenic bladder, etc. also influence the degree of disability and reduce functional dependency.

Having to rely on someone else more often for your daily living needs can hinder one’s mental health vigorously and in some cases it may also leads to suicidal tendency.

Physical Inactivity

It is said that physical activity is god for the mind and the body. Engaging in a moderate amount of physical activity will result in instant upliftment of mood and emotional states. There are a lot of said benefits of exercises and physical activities which are.

  • Improved mood
  • Good and improved self-esteem
  • Reduced symptoms of depression and anxiety
  • Reduced stress level and improved ability to cope up with stress level.
  • Increased feeling of positive energy

But due to the disability SCI patients are unable to take part in physical activities more often and hence their mental health is impacted negatively.

Poor Diet

Poor diet can contribute to many health problems including depression and anxiety. It is said the resourcesthat the chemicals present in food can instantly promote the feeling of a person. So in order to maintain a good mental health, a good diet is very important.

Neurons are the major cells of the brain which is affected by the food a person eats. An unhealthy diet, that is rich in fats and sugars causes inflammation of neurons and inhibits the formation of new neurons. This can affect the way the brain works and contribute to brain disorders like depression.

Poor diet and the low frequency of meals can also leads to fatigue an tiredness which further affects performance and mood of an individual.

Poor Sleep Quality

The whole life and life style of a person changes after SCI .Like all the other things the sleep schedule is also impacted very badly which results in poor sleep quality.Everything needs to be re-functioned and the person who is dealing with SCI has to start from the scratch.

The other complications related to SCI as discussed above are one of the major factors of disrupted sleep. Lack of sleep is associated with low energy levels, increased irritability, and reduced alertness.

Isolation

In the initial phase of the injury people are afraid to go out and live their life as earlier. And in some cases out of embarrassments people do not want go out and hang with their friends and relatives and get comfortable around their own space, which results in loneliness and isolation and triggers the mental health.

Financial problem

Some individuals with SCI may not have a good financial background or might lost their job due to their motor impairments and hence to bear the cost of proper rehabilitation and treatment of SCI is a big issue for them.

The instability in financial condition increases the stress level and causes anxiety issues.

 How to deal with these psychological effects?

So with proper management these psychological effects can be handled very well and it is very-very important to take good care of a person’s mental -health who is dealing with SCI. Spinal cord injury recovery is both a physiological and psychological challenge. While damage to the spinal cord does not directly affect psychological states, the resulting motor and sensory impairments can contribute to changes in mental health.

Failure to address the psychological effects of spinal cord injury can interfere with rehabilitation efforts and slow down recovery. Psychological management interventions generally focus on improving one’s perceived sense of control and purpose, as well as promoting a positive mindset.

We hope that this article helped you to get an idea about how SCI can affect one’s mental health. And incase if you are dealing with any of the symptoms of these psychological distress mentioned in the article then immediately consult with a mental health advisor and get help from them.

Dr. Virendra Vikram Singh(PT)

Founder & Director

KUSUM SPINE & NEURO REHABILITATION

Phone/Whats App +91-98916-66133