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Wednesday, 13 September 2017 10:57

The Importance of Rehabilitation for Spinal Cord Injury (SCI) Patients

Written by Vaqas Farooqi

By Dr. Vaqas Farooqi, Consultant of Physical Medicine and Rehabilitation at Amana Healthcare, Abu Dhabi.

 

According to the World Health Organization, between 250,000 and 500,000 people suffer a spinal cord injury (SCI) around the world, every year.

Spinal cord injuries involve temporary or permanent damage to the spinal cord that results in changes to functions controlled by the spinal cord such as movement and sensation. Patients suffering from SCI may develop tetraplegia (weakness in arms and legs) or paraplegia (weakness in legs). Both cause difficulty in getting up and walking. Several neurological functions are affected as well, such as control of bowel and bladder, maintenance of joint range, and regulation of blood pressure and temperature. In higher level injuries, breathing may be compromised and require ongoing supported ventilation.

Most spinal cord injuries are caused by trauma from road traffic accidents, violence, contact sports or falls. In the United Arab Emirates, the main causes are road traffic accidents and falls.

Along with physical impairment, SCI can also have psychological effects. Traumatic injuries are commonly associated with ‘silent’ symptoms such as emotional and psychological disturbances including depression and anxiety. Together, these effects can sometimes be even more significant than the physical disability.

Given the impact of SCI on a person’s life, it is important to ensure they receive proper care and rehabilitation as soon as possible after the originating injury.

Specialized rehabilitation is essential after a spinal cord injury and should ideally occur at a center that specializes is SCI rehabilitation. SCI Rehabilitation involves a range clinical disciplines such as physiotherapy, occupational therapy, speech therapy, clinical psychology and neuropsychology, exercise physiology, social work and vocational and recreational therapy – all working together to enable a person with SCI to recover to his or her maximum potential.

It is equally important to establish an honest partnership with patients and provide them with the right information about their recovery such as prognosis, expected outcomes, required equipment and services. SCI rehabilitation programs are intensive and focus on optimizing health, preventing complications, treating symptoms, providing therapy, improving physical function and independence and planning future discharge plans and therapy needs. All these together contribute to strengthening the potential for independence.

To commemorate Spinal Cord Injury Awareness Month, Dr. Vaqas Farooqi, Consultant in Physical Medicine and Rehabilitation at Amana Healthcare, Abu Dhabi, shares the benefits of SCI rehabilitation:

Mental health support  

People with a spinal cord injury require extensive psychiatric and psychological evaluation, support and treatments to cope with then sudden and immense loss of independence. Many patients may also exhibit behavioral changes and cognitive issues including being unable to remember or process information.

With the help of a specialized rehabilitation team, patients are encouraged to converse andparticipate in training that motivates them to avoid feeling helpless. This psychological strength will help them to develop a positive outlook and motivate them to become part of the community.

Thorough check-ups

During acute treatment, head injuries may not be explored if there is no obvious injury highlighted during radiological surveillance post-trauma. But a period of post-acute rehabilitation helps to detect and avoid further complications as detailed, comprehensive assessments on cognitive skills are conducted by psychologists, occupational and speech therapists.

Managing Pain

Pain is common after spinal cord injury and can be challenging to manage. Rehabilitation physicians have the necessary skills to diagnose, manage and monitor this. They also provide interventional pain management for SCI patients.

Guiding and encouraging family

SCI can dramatically change family dynamics. Rehabilitation teams are aware of problems that can arise with change and will consult with relatives to determine best way to move forward. This includes providing education about personal routines, preferences, and physical and non-physical problems in patients with SCI.

The road to recovery for Spinal Cord Injury patients may be long and challenging. But with rehabilitation, support from family and friends, and most importantly, determination, overcoming SCI and regaining quality of life is a real possibility – provided people get the right care.