Research into spinal cord injury recovery

Research into spinal cord injury recovery

Posted by AskNurseLinda on Jan 29, 2018 10:19 am

9b9157bb23af21df72746e66fa20180e-huge-isPotential recovery from spinal cord injury is being currently conducted. There are many options that are being studied. These include therapies to preserve and restore function, medications and surgeries. The amount of information being produced is mind boggling. There are even options that are available today but beware. Many of the treatments being pushed on the web are not proven and can cost hundreds of thousands of dollars. Participation in some of these therapies might even keep you from benefitting from treatments at a later time.

Waiting for recovery has always been an issue. It is easy to be drawn into false promises. As a consumer, there is a phrase, if it appears too easy, it probably is not worth it. I often think that if someone approaches you about a quick fix treatment, you should question why the rest of the world does not know about or is not using that particular therapy.

Reality can be tough but there has never been a time when so much progress has been made in the treatment of spinal cord injury. These studies as well as research into specific diseases that lead to paralysis are being shared and combined to enhance your opportunities. There is no magic answer but options do exist.

Therapies
Activity is the best way to keep your body healthy and to avoid complications. Research has demonstrated the benefits of activity in maintaining health and function as well as recovery. The body is always attempting to repair itself. Sometimes individuals feel that if they cannot obtain some of the advanced equipment, that the door for recovery is closed. This is far from the truth. Any type of activity provided to the parts of your body affected by paralysis will help you maintain your body.

Performing range of motion exercises either by yourself or by someone else moving your body will help to keep your joints supple and will assist with bowel, bladder and skin care. Movement of the legs and trunk keep your bowels moving and the urine in your bladder stirred, thereby reducing your chances of infection. Moving your body by performing pressure releases keeps small blood vessels from collapsing or clotting.

When moving affected parts of your body, be gentle. Sometimes when people have decreased sensation, it is easy to throw body parts around. This can include tossing a leg up on the bed or flipping a body part from one spot to another. Range of motion can become harmful when caution is not used. A body part can hit up against the wheelchair or bed or wall. People who have sensation have a natural protection mechanism because humans do not like to cause pain to themselves. Without sensation, you need to use caution to keep from harming yourself as evidenced by bruising or even bone fractures. Rough handling can lead to joint problems and deep vein thrombosis or blood clots.

Sometimes, you can find therapies in the least expected places. There might be a therapist in your town that will provide therapy at a reduced rate. Another option is using the local gym with a personal trainer who has experience with individuals with paralysis. Some rehabilitation centers open their gyms in the evening hours for a nominal fee. Finding these options can take a lot of effort. If you are active in a community with individuals who have paralysis, you can get some good leads from your friends. The Reeve Foundation Peer & Family Support Program can put you in touch with others in your community that might have the information you need or you can divide the work with them to find or even organize something in your area.

People overlook aquatic therapy for activity. Many local Y’s have pools that can be heated and personnel who have training to work with individuals with special needs. Some community centers also offer these resources. The buoyancy of the water will help you perform movements that you might not be able to do on land against gravity. Sharp movements are for resistance exercises and can be done with body parts that have movement. Be prepared for your day in the pool by performing your bowel program prior to your swim. Cover any open areas to keep the pool water out of your body. You might want to wear an adult protection garment. Be sure you discuss the idea of aquatic therapy with your health professional before starting to make sure it is safe for your specific and individual needs.

There are wheelchair sports groups that are available in many areas. These will help with general health but most often body parts with lack of movement are strapped down so not much activity there. However, you will breathe deeply and get a good workout to your moving body.

Activity can affect your mental health in a positive way so whatever you decide to do will be a great start. For all individuals, making time for activity is a challenge. It takes effort, thought and planning to develop an activity plan. You can find out what others are doing or talk with your health professional who is a good conduit of sharing information.

Medication
There are medications that are being developed to help reduce the impact of injury to your body. Some of these are specific for disease processes and some for trauma. Swelling or edema is a process that occurs whenever the body is injured anywhere-even a paper cut. Swelling in the spinal cord or brain leads to complications because these body parts are contained in rigid skulls and vertebrae. Bones do not expand to accommodate swelling which puts increased pressure on tissue and nerves. Therefore, reducing the body’s natural protection of swelling at the site of injury can reduce secondary complications and injury to the central nervous system.

Typically, the medications that prevent tissue damage from traumatic spinal cord injury are used in the early hours of injury. Sometimes, the use of these medications is not recommended depending on individual situations. Researchers are looking into ideas to better understand when and how medications should be used to benefit individuals at the time of injury.

There are medications that will help with problems that come up after injury. Medications for spasticity, infection, bowel function, bladder control and many, many others, help to keep your body in good function and can prevent further issues. Care always must be taken in regard to medication, both prescriptive and over the counter as interactions so occur.  Always report your full list of medications and have a professional monitor what you are taking to avoid interactions with the medication, supplements and food.

As scientist learn more about how the nerves in your body work, connect and transmit messages, more medication treatments will be developed that will assist with nerve signaling as well as to enhance function and eventually healing.

Surgery
There are surgical treatments available now that will help improve function. These include nerve releases, transfers and grafting. This area of surgery is probably the most explored. As mentioned earlier, there are many people ready to take you money for a ‘treatment’ that is unproven. In the past, offerings for shark tissue to be placed in your back or stem cell treatments in other countries have been advertised. People have spent large amounts of money on these types of treatments. Why are they not used as often now? Because they did not produce the results promised. Sometimes, the failure was accounted to an inability to be able to measure outcomes and yet outcome measures are readily available and standardized around the world.

Stem cell therapies and genetic therapies are being studied by researchers. Many of these treatments include surgery however, as more information is gained, these treatments may become intravenous (IV) delivered. Stem cells and genetic engineering therapies might include remyelination, regeneration or altering the body’s natural process to remove or alter diseases in addition to injury.

Peripheral nerve surgery is possible and is performed by specialty trained surgeons. Peripheral nerves are outside of the brain and spinal cord. These nerves can be rerouted or even split to improve function. Therapy is used to help your brain and body learn to activate this reorganization.

Methods of surgery for the central nervous system are being studied. A huge step forward is The Big Idea which has some of its sponsorship from the Christopher & Dana Reeve Foundation. In this process, a small implant is used to make connections in the spinal cord. Therapy is required both pre and post-surgery. The study is underway so results are not in but the preliminary study of six men demonstrated promise. Every study of spinal cord injury repair increases the knowledge base.

More than likely, a combination of all of these treatments will be used to restore function from paralysis. Activity will be needed both before and after treatment to bring the body to full recovery. Medications are used now to help people function in their daily lives but different medications specifically for recovery are being developed. Surgery to restore nerve function is underway. We have never been so close but when you are the one waiting, it can seem like forever. Now is the time to have the most hope.

Nurse LindaI'm online in this community every Wednesday from 8-9 PM ET to answer your SCI and paralysis related questions.

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