Hesperian Health Guides
Physical Therapy Following Spinal Cord Injury
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ASSISTED BREATHING AND COUGHING
Persons with spinal cord injury in the neck or upper back often have part of their breathing muscles paralyzed. Slowly the remaining muscles become stronger and breathing improves. But breathing often stays weak. The person may not be able to cough well and can more easily get pneumonia.
To help the person cough, place hands as shown below. Ask him to cough, and as he does, push firmly inward on the chest. Be careful not to move the backbone.
TWO-PERSON ASSISTED COUGH
|Do this several times a day when the person has a cold, and more often if the person develops more trouble breathing or seems to have a lot of mucus in his lungs or throat.|
ONE-PERSON ASSISTED COUGH
|To help the child breathe deep and to stimulate the breathing muscles, press lightly here while the child tries to breathe deeply in and out.
Do this for a few minutes, several times a day.
|If the person has a lot of mucus in her lungs, it also helps to lie her down, like this, and pat her back briskly. This helps loosen the mucus so that it can be coughed out. Be sure she drinks lots of water to help loosen the mucus.|
MOVEMENT AND EXERCISE
Do range-of-motion exercises for about 10 minutes for each arm and leg. In the first weeks, do the exercises twice a day. Later, once a day may be enough. If any signs of contracture develop, spend more time and effort on those parts of the body. From the start, exercises should be both passive (someone else moves the child’s body parts) and whenever possible, active (the child does it himself).
Range-of-motion exercises should begin with great care the day after the spine is injured. The exercises will help to improve the flow of blood (which reduces the chance of bed sores), to prevent contractures, and to build the strength of the muscles that still work. Range-of-motion exercises should be continued throughout life, when possible as a part of day-to-day activity.
but not when it is bent back like this.
This way enough contracture is left to be useful for taking hold of things. Although the fingers lack movement by muscles, they close around an object when the wrist is bent back.
If possible, get instructions from an experienced physical therapist.