Welcome

Title:
Rehabilitation for Improving ADL of
Paraplegic Patient from Spinal Cord
Injury

Presented by,
Sraboni Biswas
4th year, Roll: 10
Session: 2017-18
Introduction
Spinal Cord Injury (SCI) is injury that occurs to spinal cord from
foramen magnum distal to the conus medullaries & cauda equinae(Chen
et al, 1996) . Acute injury of spinal cord is the most common cause of
sever disability & death(Jenkins et al, 1996) . Spinal Cord Injury (SCI)
which results in disruption of the nervous transmission can have
considerable physical and emotion consequences to an individual's
life(Eng et al, 2006,. JAMES et al ,2003).
Patients with Spinal Cord Injuries (SCI) are confronted with motor and
sensory deficits as well as bladder, bowel and sexual dysfunction, which
lead to a fundamental change of life(Chen et al, 1996).

Paraplegia results from injury to thoracolumber or sacral segment. This

include injury to the conus medullaris and cauda equine. This condition
affacts an individual’s personal , emotional,and social life by limiting
his\her activities of daily living.
Evidence of the benefits of medical rehabilitation is documented by the

reduction in disability of person receiving in patient rehabilitation.

Many patients with spinal cord injuries are able to go home after the

rehabilitation period and a significant number achieve a reasonable

degree of independence in the performance of daily living

skills(Yarkony et al, 1988).

Case study

A 23-year-old man who had paraplegia from a C7–T1 subluxation as a

result of a motor vehicle accident in July 2022, presented with complete
loss of clinically detectable voluntary motor function and partial
preservation of sensation below the T1 cord segment. He is a student.
He lives in rural area with 5 family members.
Problem list

• Weakness of lower limb muscle

• Partial loss of sensation in the lower half of the body

• Increased tone

• Decreased joint range of motion

• Balance and coordination problem

• Difficulty walking and standing

• Bawel and bladder problem

• Limitation in ADL
International classification of functioning,
Disability and Health (ICF)
The ICF is a classification of health and health related condition for

children and adults that was developed by World Health

Organization(WHO) in 2001.

Components of ICF:
• Body function and structure
• Activity and participation
• Environmental factors
• Personal factors
In this case according to ICF,

• Health condition= Spinal cord injury, paraplegia

• Problem in body function = weakness in the lower limb muscle,
decreased ROM,
• Activity limitation = difficulty in walking, stair climbing, micturition,
defecation
• Participation restriction = restricted participation in  recreational,
social, educational and vocational activities. 
• Environmental factor = Live in rural area, public transport, house
design
• Personal factor = 23 years male, student, 5 family member
Aim of rehabilitation
 Improving the ability of ADL
 Increase self dependancy
 Improving quality of life
Relation with poverty
• Spinal cord injuries (SCI) are becoming more common at present and
it is one of the most traumatic events to occur in an individual’s life.
Spinal cord damage below Thoracic 1 (T1) level is termed
paraplegia(Jacques E ,2014)
• Traumatic paraplegia is most prominent among young men between
the ages of 21 and 35 years and it affects a part of the economically
active population(Young W ,2013)
• So the consequence of this condition brings a negative impact on the
economy of the family as well as the country.
 Rehabilitation

 Physical therapy generally focus on -

• Postural education
• Reducing muscle tone
• Maintaining or improving range of motion and mobility
• Increasing strength and coordination and improving comfort
Balanced Exercise Program :
• Stretching Exercises
• Strengthening Exercises
• Aerobic Exercises

Gait Training


Transfer training


Hydrotherapy


Assistive Devices:

•Canes

•Wheelchair

•Orthosis

•walkers
(Susan. B. Osullivan, Thomas. J. Schmitz, Physical 
Rehabilition, 4th edition. F. A Davis company, 
•
Philadelphia.)
Conclusion

Rehabilitation of paraplegia is a multidisciplinary approach and this

review will help in providing an outline about the rehabilitation of
paraplegic patients and hopefully provide some direction not and
recommendations for practitioners working in the fields of
rehabilitation.
 Referances
1. Chen D, Yarkony GM. Rehabilitation of patients with spinal cord injury. In: Braddom RL,ed.
Physical Medicine & Rehabilitation. 1st ed. Philadelphia: W B Saunders Company. 1996;
55:1149-1150.
2. Jenkins AL, Vollmer D. In: WInn HR,ed. Youmans neurological surgery. 5th ed. Philadelphia: W B
Saunders company. 1996; 315(4): 4885.
3. Eng JJ, Miller WC et al. Rehabilitation from beside to community following spinal cord injury. In:
Eng JJ, Teasell RW. et al, ed. Spinal cord injury rehabilitation evidence. 2006;1:1-11.
4. JAMES JJ, Cardenas D D. Spinal cord injuries. In: Garrison SJ, ed. Hand Book of Physical
Medicine & Rehabilitation. Philadelphia: Lippincott Wiliams & Wilkins. 2003; (2)19:270-287.
5. Susan. B. Osullivan, Thomas. J. Schmitz, Physical  Rehabilition, 4th edition. F. A Davis company, 
Philadelphia.
Thank You