Yes You Can - Fourth Edition - 50

Perform daily range-of-motion exercises. [See section 2.c, Limb Preservation and Posture.] Avoid stimulation that aggravates the spasticity, such as fast movements or certain body positions. During a spasm, protect your feet and legs from striking sharp or hard objects, like hitting your wheelchair during a transfer. Ask your therapists about the use of padded straps and splints to help control spasticity. Take a warm [not hot!] bath or shower. Talk to your health-care provider about wheelchair options, such as shock absorbers. Talk to your health-care provider about other treatment options. For spasticity that can’t be controlled with those treatments, other options include the following: Oral medications [but, like all medications, each one has side eﬀects]. Injection of a speciﬁc medication into a muscle or nerve to reduce spasticity. Intrathecal medication—medication delivered directly to the spinal canal from a pump implanted under your skin by a surgeon. The pump is reﬁlled with medicine at regular intervals by a health-care provider. Surgery to nerve roots or to the spinal cord. of paralyzed muscles can sometimes be partially reduced by using electrical stimulation treatments to make the muscles contract. However, each muscle must be stimulated, and if the treatments are stopped, atrophy will return. Electrical stimulation will not restore voluntary strength in completely paralyzed muscles. This treatment is usually very time-consuming and costly compared with the beneﬁts. Contractures Contracture is tightness of tissues around joints and in muscle that limits joint movement and function. Contractures can be a serious problem, but they are preventable. If you neglect range-ofmotion exercises, contractures can permanently limit your joint movement. Contractures can interfere with transfers and daily activities and can change your posture, which can lead to pressure ulcers. In some persons with tetraplegia [cervical injury level and weakness of arm muscles], tightness of ﬁnger muscles is actually promoted to improve the grip. When the wrist is extended [raised backward], muscle tightness causes the ﬁngers to bend down toward the palm and thumb. This method of adaptive grasp and release is called “tenodesis”—it can give a weak but functional grip to some people whose ﬁnger muscles are completely paralyzed. Muscle Atrophy Atrophy is the shrinking of muscle size when a muscle is not used. Some people with SCI develop more atrophy than others. Atrophy generally is not a medical problem. However, if your muscles get smaller, you’ll have less padding over bony spots where pressure ulcers can form—such as sit bones, heels, or shoulders—and you’ll need to avoid long-term pressure on these spots. Spasticity may help decrease the amount of atrophy by keeping the muscles active. Atrophy Prevention Contractures can be prevented by moving joints through their full range of motion regularly. Joints in body areas where the muscles do not work must be moved manually by you or your attendant. Shoulders, elbows, hips, knees, and ankles are the joints in which it is most important to prevent contractures. If you have severe spasticity, rangeof-motion exercises may be particularly important and you may need to do them several times a day. [See section 2.c, Limb Preservation and Posture.] [ 50 ] | Yes, You Can!

Yes You Can - Fourth Edition

Table of Contents for the Digital Edition of Yes You Can - Fourth Edition