Paraplegia And Physiotherapy Treatment :

Paraplegia And Physiotherapy Treatment : 

 Paraplegia is paralysis or weakness (paraparesis) of both lower limbs. :

    It may be due to:

• Pyramidal (U.M.N.) lesion resulting in spastic paraplegia.
• Lower motor neurone (L.M.N.) lesion resulting in flaccid paraplegia.

Paralysis Treatment At Home in Ahmedabad

    It is paralysis or weakness of both lower-limbs due to bilateral pyramidal tract lesion, most commonly in the spinal cord (spinal paraplegia), and less commonly in the brain stem or the cerebral parasagittal region (cerebral paraplegia). Symptoms Mainly Unable To Walk, Stand, With Or Without Sensory Loss in Bilateral Lower Limb And With Also Affected Bladder / Bowel Incontinence.

Spinal paraplegia may be:

    1.Focal: paraplegia with sensory level.
    2.Systemic.
    3.Disseminated.


Reason Of PARAPLEGIA:

1- Focal causes:

    A. Compression:
    1. Vertebral:
Fracture or fracture-dislocation of the vertebra, Disc prolapse and spondylosis, Pott’s disease, Neoplastic 

diseases: Primary or metastatic and Deformity of the vertebral column as kyphoscoliosis.

TREATMENT  OF PARAPLEGIA: 

1. General Management:

    Frequent change of the patient’s posture to guard against bedsores.
    Care of the skin by frequent washing with alcohol followed by talc powder. In case of urinary incontinence, frequent change of  bed-sheets.
    Care of the bladder: If there is retention, use parasympathomimetic drugs. If this fails, use a catheter to evacuate the bladder.

2. Physiotherapy Treatment:

Paralysis Treatment in Bapunagar

(1) Stretching/Flexibility Exercises:

• slow, sustained lengthening of the muscle
• Stretching is the most important exercise you can do.
• Stretching improves flexibility – the ability to move the parts of your body through their full range of motion.
• Stretching also can reduce muscle spasticity and cramps and may also reduce problems such as tendonitis and bursitis.
• To be effective, stretching routines must be done regularly, usually once or twice a day.
• Stretch as far as you can and hold the stretch for 10 seconds and then ease back.
• Stretching also should be done before and after other exercises to prevent muscle strain and soreness and to help avoid injuries.

(2) Aerobic Exercises:

    Steady exercise using large muscle groups
    Aerobic exercise strengthens your heart and lungs and improves your body’s ability to use oxygen. It also reduces fatigue, increases energy levels and helps you sleep better, control your weight, and lift your spirits.
    It is generally recommended to gradually work up to three or four sessions per week, each lasting 15 to 60 minutes. Include a 5-minute warm-up (including stretching) before the activity and 5 to 10 minutes of a cool down (stretching and slower activity) afterwards.
    Walking, stationary bicycling, water exercises and chair exercises are excellent choices.
    Walking: Experts recommend walking according to your ability, comfort and safety. Even short, slow walks can provide benefit.Aquatic (water) exercises: Aquatic exercises and swimming provide optimal exercise conditions. Water eliminates the effects of gravity, allowing weakened limbs to attain a greater range of motion. 

Water also helps support the body so there is less stress on hips, knees, and spine.
    Exercises in the water: Can help increase muscle power and endurance and help mobilize joints and muscles. 

They also help to relax muscles and improve coordination. Warm water (between 83 and 90 degrees F) can be especially good for stiff, sore joints. Exercises can be done while standing in shoulder-height water or while sitting in shallow water. In deeper water, an inflatable tube, floatation vest or belt can be used for flotation.
    Stationary bicycling: Stationary bicycling is a great way to improve fitness without putting stress on hips, knees, and feet. It can be done in any weather, and balance is generally not an issue. Add resistance only as you are comfortable and only after warming up.
    Chair exercises: If mobility and balance are big issues, consider chair exercises. They can provide a great workout and easily incorporate strengthening and stretching exercises.

(3) Strengthening Exercises:

    Repeated muscle contractions until the muscle becomes tired.
    Strengthening exercises help increase muscle tone and improve the quality of muscles. This enhances mobility and provides energy and a positive sense of well-being.
    Strong hip and leg muscles are needed to lift the legs to walk, and strong arm muscles are needed to carry out daily functions. Strong abdominal and back muscles help maintain correct posture and can counter pain resulting from poor gait, poor posture or the use of mobility aids.

Electrotherapy Treatment :

    Thermotherapy: are used to decrease the pain and spasticity. 
They are (i) Superficial heat:IRR, wax bath, etc. 

(ii) Deep heat: SWD, MWD, etc.
    Electrical therapy: is used to increase muscle power and to decrease the pain. e.g, TENS, EST, IFT.

Physiotherapy Technique  :Useful in Improving Condition Are : 

• Mat exercise.
• PNF exercise.
• Active and passive ROM exercise.
• Strengthening exercise.
• Stretching exercise.
• Endurance exercise
• Co-ordination exercise.
• Pelvic tilting exercise.
• Hamstring muscle stretching.
• Spinal rotation.
• Calf muscle stretching.
• Neck raising exercise
• Knee rolling exercise.
• Lying in extension.
• Extension exercise.
• Back and gluteal exercise.

3 . Symptomatic Treatment:

• Analgesics and sedatives for pain.
• Muscle relaxants for the spasticity.
• Vitamins and tonics

4. Orthosis:

• Various orthosis are used to assist patient with paraplegia.
• These are: crutch, walker, cane, brace and wheelchair.

5. Gait training:

    It is the important part of rehabilitation program balance can be achieved by proper gait training. Gait training can be done by following methods:
    Pre ambulation MAT program:
    Rolling, prone on elbow, prone on hand, quadruped, pelvic tilting, setting and standing balance.
    Parallel bar progression
    Advanced parallel bar activities.
    Assistive device: E.g, Cane, crutches, walker

6. Home program and Ergonomics:

    Patient is advised to use the lumbosacral orthosis to support the back during traveling.
    Patient is advice for hot fomentation at home.
    Patient is advised to lying in prone position for at least 15 minutes duration twice in a day.
    Patient is explained about the proper sitting, standing, lying and lying to standing , doing the household activity in a proper way.
    patient is advised to take rest and to avoid the forward bending as much as the patient can avoid.