The duration of rehab sessions for spinal cord injury may vary depending on the factors such as age, co-morbidities, pre-morbid function, level of injury, severity of injury, tolerance to therapy etc. Apart from the sessions, the therapists will instruct you how to get out of bed safely, sit on a wheelchair or get up from it, instruct your own care, and signs of discomfort. On a general note, they may instruct on how to maintain the posture while taking a bath, getting dressed, and on other daily living activities.

Exercise – As a main tool of rehabilitation, exercise improves body strength and mobility. Exercise essentially functions as a feedback loop. We make movements during exercises according to instructions from the brain. When this movement is done, it provides positive reinforcement to the brain that nil pain is experienced. That, in turn, helps you to expand your mobility and strength while simultaneously training the central nervous system that such movements are safe. Exercise also improves balance, coordination, posture and endurance.

Ultrasound – This is a deep heating modality that is applied to the skin. Ultrasound therapy is beneficial in treating fractures and blood clots due to injury. Usually, a hand-held transducer is deployed for this purpose and is moved over the injured area. The transducer produces high pitched sound waves that heat the tendons, muscles and tissues. As a result, there is an improvement in the blood flow thereby enhancing the circulation and expediting the healing process.

Electrical Stimulation – Here, electrodes are inserted to the patient skin and electric impulses are used to provide pain relief, functional improvements and even treat neurological disorders. Transcutaneous Electrical Nerve Stimulation (TENS) is a form of this approach that is used to manage acute and chronic pain by sending non-painful stimuli to the injured parts and nervous system.

Massage – Some physical therapists use the massaging technique to decrease joint inflammation and muscular rigidity. It improves blood circulation and reduces stiffness.

Dry Needling – As one of the latest forms of rehabilitation, dry needling is used by therapists to lessen the painful muscular knots and trigger points. Small needles are pierced into the muscle tissue and knotty areas to provide pain relief.

Heat Therapy – Dry heat is known to be a good soother for sub-acute and chronic injuries and muscle soars. The applied heat affects merely the skin, fat layer and superficial tissues and has localized effects to reduce pain, enhance mobility and temporarily ease movements. Damp heat packs may also be useful as they penetrate deeper and faster into the injured areas and promote functional improvements.

Ice Packs – Ice packs decreases inflammation and passage of blood to temporarily prevent swelling of injured muscles and joints. It is widely used to reduce inflammatory response after therapeutic exercise.

Patient Education –Latest research reveals that teaching patients about the pain experienced and its associated causes can create better awareness and provide a positive impact on the rehabilitation. It eliminates the fear of the unknown in human minds. The therapists provide a detailed explanation about the pain effects, alleviation and management.

Light Treatment – Lasers or light-emitting diodes are used to transmit light to injured tissues. These rays are absorbed to generate cellular energy for the body repair processes. This therapy is beneficial in wound healing and treating low back pain.

• Presence of Dysphagia (difficulty in swallowing)
• Presence of Drooling of saliva
• Presence of Difficulty in chewing
• Presence of food residues inside the mouth

Presence of Abnormal volitional cough, abnormal gag reflex, cough after swallow, and voice change after swallowing
Up to 50% of acute stroke patients are likely to experience dysphagia. If it is not recognized early, dysphagia may be responsible for aspiration, aspiration pneumonia, and/or undernutrition and dehydration. Stroke patients with dysphagia are likely to have poorer outcomes.

 

Therefore, dysphagia screening should be undertaken as soon as possible after the patient has been admitted to hospital and before starting oral intake of food, fluids, or medication. After a complete comprehensive assessment, the SLP will come up Head Positioning for oral intake and motor sensory stimulation A sensory stimulation program to encourage swallowing activity if no level of oral intake appears ‘safe’ Using certain swallowing maneuvers such as supraglottic swallow, super supraglottic swallows, Mendelssohn’s maneuver etc.

 

Oromotor exercises for proper chewing and to reduce drooling Texture ,taste and temperature modifications and specification for all oral intakes Feeding objects modifications and specifications for all oral inatkes

 

Recommendations for oral medications

Requirements for meal-time monitoring, including indicators of poor swallow functions. The third part of evaluation involves diagnosis for communication involvement particularly with regard to

• Presence of dysarthria and dysphonia (inability to utter sounds in a proper manner)
• Presence of Aphasia (inability to understand the instructions and express their needs either verbally or non verbally)
• Presence of Apraxia (inability to perform simple motor tasks in response to commands)

However almost 70% of stroke survivors are likely to develop Dysarthria, made possible by potential respiratory, phonatory, resonance, and/or articulatory system impairments. The SLP will come up with Exercises to improve the respiratory/phonatory parameters underpinning speech may include non-speech, postural, and speech activities Resistance training techniques which can target respiratory and/or phonatory muscles directly when reduced strength is hypothesized Among stroke survivors, 30-60% is likely to experience a communication deficit. Communication deficits have been demonstrated to be associated with depression and therefore, by inference, with quality of life. The part of the communication assessment undertaken by the SLP is to examine the communication environment which impacts on the stroke survivor. During the post-stroke stage,

 

The SLP will come up with:

 

• What communication devices, if any, can support the stroke survivor in their efforts to communicate
• What communication strategies can be employed by communication partners to enhance communication with the stroke survivor
• What education is required by communication partners (including family, significant others, and staff) to employ the identified strategies
• What support the stroke survivor requires to access written information relevant to their care
• What support the stroke survivor requires to access leisure time activities in their own environment.

Stroke survivors who demonstrate impairment in the areas of attention and memory will frequently have concomitant communication involvement. The SLP will also work to minimize the impact of these cognitive impairments on communication. In particular, areas such as verbal attention, divided attention, sustained attention, auditory memory, verbal memory, visual neglect and executive functions which have a direct impact on communication. The SLP will come up with

 

What attention strategies and memory strategies, if any, can be employed by communication partners to enhance effective communication with stroke survivors. Rehabilitation plays a significant role in helping people get integrated into an active community. Check with your nearest pulmonary rehabilitation clinic for a thorough examination, today.