Spinal cord injuries can happen in a variety of ways, a traumatic injury or a disease. These types of injuries result in damage to the spinal cord. 

Difference Between a Complete Spinal Cord Injury and Incomplete Spinal Cord Injury


Spinal cord injuries (SCI) can happen in a variety of ways, whether that’s
through a traumatic injury (i.e. motor vehicle accident, shallow diving, acts of
violence, or sports injuries) or a disease acquired at birth or later in life
(i.e. tumors, electric shock, loss of oxygen related to surgical or underwater
accidents). These types of injuries result in damage to the spinal cord by a way
of dislocation, compression, fracture, burst, hyperextension, or hyperflexion.
The spinal cord doesn’t have to be cut in order to have a loss of function.

Understanding the levels of Spinal Cord Injury

Cervical Spinal Cord injury- C1-C8: Cervical spinal cord injuries results in
paralysis or weakness in the arms and legs which results in quadriplegia. This
region of the spinal cord controls our head, neck, arms, legs, and diaphragm.
Our neck is so fragile do to its flexibility that it makes it difficult to
stabilize after an injury so it may result in the person wearing a neck brace or
a stabilizing device. Cervical injuries are accompanied by loss of sensation,
bowel and bladder function, regulating body temperature, and sexual dysfunction.

Thoracic Spinal Cord Injury-T1-T12: Thoracic spinal cord injuries are not as
common due to the protection it receives from the rib cage. These types of
injuries cause paralysis or weakness in the legs along with loss of physical
sensation, bowel, bladder, and sexual dysfunction. Arms and legs are not usually
affected in these types of injuries. To help produce stability for the trunk
patients usually wear braces around the abdomen.

Lumbar Spinal Cord Injury- L1-L5: Lumbar spinal cord injuries only affect the
lower extremities which also is referred to paraplegia. Physical sensation,
bowel, bladder and sexual dysfunction can also be lost during these types of
injuries. Lumbar injuries usually require surgery and external stabilization.
The lumbar region of the spinal cord controls signals to the back, abdomen, and
buttocks, along with some aspects of the external gential organs.

Sacral Spinal Cord Injury- S1-S5: Sacral Spinal Cord injuries cause loss of
bowel, bladder and sexual dysfunction. They can cause weakness and/or paralysis
in the hips and legs. Sacral region of the spine controls signals to the thighs,
lower parts of legs, feet, and gential organs

There are two types of spinal cord injuries: Complete and incomplete injuries.



Complete Spinal Cord Injury happens when the spinal cord is compressed or
severed completely which affects the ability of the brain to communicate motor
and sensory functions to the body below the level of injury. Symptoms of a
complete spinal cord injury could be loss of sensation below the level of
injury, complete loss of function below the level of injury, unable to control
bowel or bladder, and depending on how high the level of injury is a person
could have difficulty breathing.

Incomplete Spinal Cord Injury happens when the spinal cord is compressed or
injured but the brain still has the ability to send signals below the site of
injury. The effects of this type of injury vary. Symptoms of an incomplete
spinal cord injury could be retaining some sensation below the site of injury
that comes and goes, being able to move some muscles below the level of injury
or pain having chronic pain below the level of injury. For example, a patient
recovering from a spinal cord injury from an infection may regain a large about
of function back.

Spinal cord injuries are unpredictable and vary from person to person depending
on the level and type. After a spinal cord injury the goal is to restore as much
function as possible to a person's body in order to perform activities of daily
living (i.e. cooking, getting dressed, showering, bathing, toileting, etc) and
get back to living life. The best way to do this is to find a good inpatient
hospital or outpatient center with intense therapy to help teach you ways to
increase your daily function whether that's through exercises, compensatory
techniques, or assistive technology. Throughout the process of recovering from a
spinal cord injury it is vital to remember that each patient still can fulfill
their dream of living life to the fullest it may just look different.

Spinal Cord Injury

Improve Spasticity after spinal cord injury. Spasticity is the overexcitability of a muscle in response to movement. It’s a hyper exaggerated stretch reflex

Improve Spasticity After Spinal Cord Injury NEOFECT Smart Rehab

WHAT IS SPASTICITY?
Spasticity is the overexcitability of a muscle in response to movement. It’s a
hyper exaggerated stretch reflex. Essentially when a joint is moved quickly the
muscle tightens. This signal to tighten the muscle isn’t coming from the brain,
but rather that the brain has difficulty sending signals to stop the reflex from
happening.



Spasticity has also been used as a general term to describe other symptoms seen
in conditions where damage to the central nervous system has occurred. Symptoms
such as a sustained muscle contraction at rest, which makes movement of the
joint rigid and inflexible. This can cause joint contractures
[https://www.neofect.com/us/blog/how-do-i-prevent-hand-contracture-after-a-stroke]
. You might also see a muscle tightness when you're trying to perform an
activity with your other hand.

There are several mechanisms that contribute to spasticity in people with spinal
cord injury. Typically the brain stem is able to manage the rate of motor
neurons that are firing. Depending on the level of injury the brain stem is
unable to send a message to a particular muscle below the level of injury. The
muscle contraction becomes a reflex loop from the muscle to the spinal cord and
the brain is unable to reach the muscle to stop it because the pathway has been
cut off.

People with spinal cord injury
[https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/syc-20377890] 
also have difficulty sending a message to the antagonist muscle. Each joint
movement has an agonist (primary muscle mover) and an antagonist (stabilizing or
opposing) muscle. For example, the elbow joint is moved by the biceps and
triceps muscle. To bend the elbow the biceps muscle fires up, but the triceps
muscle is also involved to manage the timing of the movement and release back to
a neutral position. Each joint and each movement typically use a combination of
muscles to allow smooth movement of upper and lower body extremities.



MANAGING SPASTICITY
It’s important to note that not all spasticity is bad. Many people with spinal
cord injury use their spasticity to assist with standing, transfers, and daily
activities. It’s important to discuss options for managing spasticity and
functional implications with your physician and your occupational or physical
therapist.

There are two general approaches that address spasticity: medical management and
physical management. Medical management is decided in collaboration with the
patient and physician. It addresses the neural component that is causing the
muscle tightness. Medical management of spasticity includes oral medications,
neurotoxin or phenol injections, and surgical interventions.

The physical management is typically addressed by a physical or occupational
therapist and addresses the biomechanics of the joint to prevent muscle
shortening, joint deformities, and decreased function. Physical management
includes proper positioning, stretching, and muscle strengthening. Physical and
occupational therapists also use electrical stimulation and ice as modalities to
limit spasticity during exercise or functional activity.

PROPER POSITIONING



Proper positioning should be considered when seated and lying down. Supports
should be given to keep the joints in alignment and symmetrical. When lying
down, use pillows or towel rolls to prevent scissoring or a windswept position
of the legs. If using a wheelchair, positioning can assist with extensor tone in
the hip when the feet are supported. Wheelchair arm supports can also help
support the arms, which will prevent dangling and accidental activation of the
stretch reflex. If you’re having difficulty with extensor tone in the legs,
manually moving one knee into flexion can break up the tone to position the hips
in the wheelchair.

STRETCHING

Spasticity tightens our muscles and over time the muscle begins to shorten. This
limits our ability to move our joints even further. Stretching has the potential
to quiet the hyper exaggerated reflex for several hours, as well as the benefit
of maintaining range of motion. Stretches should be held for 30 seconds or more
and you may feel a release of the muscle tone.

Splinting and orthotics are used for an even longer stretch. They position a
joint optimally to maintain length of a muscle and prevent contractures.
Depending on the purpose, splints and orthotics are worn during the day or at
night to allow for hours of stretch time.

Weight-bearing and standing are also forms of prolonged stretching with the
added benefits of strengthening and increasing bone density. Weight-bearing also
inhibits the reflex movement pattern.

STRENGTHENING



Strengthening can improve spasticity in two ways. By strengthening the
antagonist (opposing) muscle, it can help inhibit the reaction of the spastic
muscle. When the spastic muscle activates and tries to pull a joint into
flexion, the extensor muscle has the capacity to limit the flexion just by being
stronger.

We must also strengthen the spastic muscle. It might seem that with all that
contracting a spastic muscle would be a strong muscle, but without the brain to
muscle connection a spastic muscle is actually a weak muscle. Utilizing
electrical stimulation or ice prior to strengthening a spastic muscle may be a
way to optimize your strengthening session.

Strengthening can happen any time a muscle is contracted, but depends on the
capability of the person doing the contracting. It has to be somewhat difficult.
The muscle has to fatigue. The person who does not have full active range of
motion, but is able to visibly contract a muscle is strengthening with each
repetition of movement.

Repetition of movement is a rehabilitation strategy not only for strengthening,
but plasticity. Intensive repetitive training or massed practice enhances
sensory motor recovery after spinal cord injury.

INTENSIVE REPETITIVE TRAINING

Voluntary movement has the potential to maintain joint range of motion,
strengthen, and increase plasticity
[https://www.brainhq.com/brain-resources/brain-plasticity/what-is-brain-plasticity/]
. But it’s all about repetition. In a typical therapy session, you might expect
to do 20-30 repetitions of movement. You would be responsible for completing the
movements for each joint on a daily basis. This can become boring and the habit
slowly slips away.



Talk to your therapist to help find motivating exercises and activities that
encourage you to complete lots of repetitions within your capabilities. Staying
engaged to maximize repetitions performed is key. Every person is unique and has
a different rehabilitation journey. Neofect has experienced occupational
therapists to consult with to see what might work for you.

To learn more, please call (888)623-8984 or email info@neofect.com.

All content provided on this blog is for informational purposes only and is not
intended to be a substitute for professional medical advice, diagnosis, or
treatment. Always seek the advice of your physician or other qualified health
provider with any questions you may have regarding a medical condition. If you
think you may have a medical emergency, call your doctor or 911 immediately.
Reliance on any information provided by the Neofect website is solely at your
own risk.

Spasticity

How Can I Improve Spasticity After a Spinal Cord Injury?

Home exercise programs are important for a spinal cord injury to increase function and maximize recovery and also to prevent further physical limitations.

Home Exercise is Important After Spinal Cord Injury 



Home exercise programs are particularly important for people with spinal cord
injury [https://www.shepherd.org/patient-programs/spinal-cord-injury/about], not
only to increase function and maximize recovery, but to prevent further physical
limitations.

While spinal cord injuries are non-progressive, patients are likely to
experience muscle atrophy or develop joint contractures
[https://www.neofect.com/us/blog/how-do-i-prevent-hand-contracture-after-a-stroke] 
from poor positioning, lack of movement, and muscle tightness. People with
spinal cord injury are also at high risk for cardiovascular disease.



Home exercise programs should be tailored to a patient’s individual needs, as
there are many individual factors that affect participation and optimal
outcomes. A physical or occupational therapist can assist with customization,
but home programs should include cardiovascular exercises, exercises to maintain
range of motion, and muscle strengthening.

Cardiovascular Exercise


Cardiovascular exercise
[http://sci.washington.edu/info/forums/reports/exercise_2013.asp] involves
increasing the heart rate and rate of breathing. Cardiovascular exercise
improves the way the heart and lungs function. Depending on the level of injury
there are many ways to accomplish this using just the upper body, including:
pushing a wheelchair, using an arm bicycle, seated aerobics, rowing, and Wii or
Kinect video games (boxing, dancing, etc). You just gotta get that heart
pumping!

Make sure to check in with your physician before starting an exercise program.
Of particular note: people with spinal cord injuries at or above the T6 level
are at risk for autonomic dysreflexia
[https://www.christopherreeve.org/living-with-paralysis/health/secondary-conditions/autonomic-dysreflexia]
, which is simply the body’s protective responses going into overdrive which can
have serious consequences if intervention is not given rapidly. Prior to
starting an exercise program, patients should be aware of their baseline blood
pressure and the symptoms of autonomic dysreflexia.

Maintaining Range of Motion


Passive range of motion is needed to maintain movement in a joint. If you don’t
move it, you lose it! Think of the movement like opening and closing a door.
Each time you move the joint, it’s like putting oil on the hinge of a door. If
you don’t ever open the door, the hinge will get rusty and you won’t be able to
open the door easily. We want to keep as much joint mobility as possible because
tight joints make getting dressed and showering much more difficult.

Depending on the level of injury and whether a spinal cord injury is complete or
incomplete will determine which joints need to be passively moved through their
range of motion. This can be done by either the patient or caregiver.

Strengthening


Strengthening of a muscle happens with repetitions of muscle contractions to the
point of fatiguing the muscle. Think of a person at the gym doing a bicep curl.
To build strength you need to use enough weight that the muscle is fatigued
after 10-15 repetitions of movement. Typically for strengthening you would
complete 3 sets of 10-15 repetitions with 1-2 minutes of rest between each set.
To build endurance, you would use a lower weight and complete 3 sets but
increase the number of repetitions to 20 or 30 with shorter rest breaks between
sets.

Even if you’re not using weights, simply activating that muscle and moving
through the range of motion using the same parameters will build strength. The
other important thing to consider is gravity. It makes a huge difference! If a
person is able to activate a muscle, but cannot move against gravity, they can
try repositioning their body at a different angle that takes gravity out of the
equation. Once they gain strength in a gravity eliminated plane, they can
progress to against gravity, then light weights, then slowly increase the
weight.

The other way to strengthen is by participating in your daily activities to
whatever extent you are able. Everytime you push your arm through the sleeve of
your shirt you are activating your tricep muscles. Everytime you eat and bring
your hand to your mouth, you’re activating your bicep muscles. It’s a balance of
allowing someone to assist and taking on as much as you are physically able.

Staying Engaged in Exercise
Finding motivation to complete a home exercise program is a universal problem
throughout rehabilitation, and yet it’s so important! It’s impossible to gain
strength in the 1-2x a week session a patient is seen for OT or PT. To combat
this, make sure your exercise program is tailored to your interests. Involve
friends and family who will follow along with your progress and hold you
accountable.

Ultimatelly, maintaining motivation is worth more than just a physical payoff
the long run. It’s not just about strengthening, it’s about finding what
activities matter to you. It’s the meaningful activities we do everyday that
improve our quality of life.

All content provided on this blog is for informational purposes only and is not
intended to be a substitute for professional medical advice, diagnosis, or
treatment. Always seek the advice of your physician or other qualified health
provider with any questions you may have regarding a medical condition. If you
think you may have a medical emergency, call your doctor or 911 immediately.
Reliance on any information provided by the Neofect website
[https://www.neofect.com/us/for-home] is solely at your own risk.

Why Home Exercise Programs Are Important After Sustaining a Spinal Cord Injury

Although modern medicine has not yet found a way to cure paralysis, modern technology is starting to bridge the gap.

Technology Continues to Evolve to Allow for Increased Independence After a Spinal Cord Injury

Life after a spinal cord injury can sometimes feel a little hopeless because you
have to rely on someone else for everything, even simple everyday tasks like
feeding yourself or brushing your teeth. Although modern medicine has not yet
found a way to cure paralysis, modern technology is starting to bridge the gap.
Over the years modern technology continues to introduce exciting new ways that
allow people who are paralyzed to regain some functionality back and, better
yet, regain hope!

Functional Devices Assist with Everyday Tasks
Over the years there have been many functional splints and devices created to
assist people with everyday tasks. One of the most commonly used functional
device is called a universal cuff. A universal cuff can be used in a variety of
ways such as to hold a feeding utensil, tooth brush, or makeup brush ect.
Depending on the level of the spinal cord injury one may require a wrist support
splint along with the universal cuff or a mobile arm support which will provide
a gravity eliminated position for the upper extremity, which will allow for
active movement while utilizing less muscle strength.



Another common practice is utilizing foam to build up objects such as feeding
utensils, tooth brush, or writing utensils. However, if someone needs a little
more support for writing they may be recommended a functional writing splint
such as a figure eight splint or a Wanchik Writer splint.



There have been many other devices and custom splints created in order to
perform fun activities such as gardening, fishing and painting.

NeoMano: Regain Hand Function and Independence
All of these splints and adaptive devices are great and very functional.
However, Neofect has created a robotic assistive device called NeoMano
[http://neomano.neofect.com/] that helps with hand motions in order to give
people back their hand function and independence while only requiring one
device. NeoMano is a wearable robotic glove [http://neomano.neofect.com/] that
assists with the grasp and release of objects. The glove is a partial-glove
design that enables the thumb, pointer and middle finger to perform grasp and
release motions.

NeoMano can assist people with everyday tasks such as feeding, writing,
exercising, and daily grooming tasks. People have even rediscovered old hobbies
with the use of NeoMano, like golfing and photography! If you’d like to get one
for yourself or a loved one, you can for the fraction of the market price by
visiting our Indiegogo campaign. [https://igg.me/at/neomano]



To learn more about the NeoMano, call (888) 623-8984 or email info@neofect.com.

robot hand glove

Evolving Technology Offers Increased Independence in Spinal Cord Injury Recovery

Life after a spinal cord injury can sometimes feel a little hopeless because you have to rely on someone else for everything, even simple everyday tasks.

How the NeoMano Can Help You Become More Independent After a Spinal Cord Injury



Life after a spinal cord injury can sometimes feel a little hopeless because you
have to rely on someone else for everything, even simple everyday tasks like
feeding yourself or brushing your teeth. Although modern medicine has not yet
found a way to cure paralysis, modern technology is starting to bridge the gap.
Modern technology is beginning to introduce exciting new ways that allow people
who are paralyzed to regain some functionality back and, better yet, regain
hope!



First, let’s start with a little anatomy lesson about the spinal cord. The
spinal cord is made up of four regions - the cervical spine, the thoracic spine,
the lumbar spine and the sacral spine. The spinal cord is especially important
because it provides the pathway that messages travel from the brain to the rest
of the body when you decide to move your hand towards a glass of water and grasp
it so you can take a sip. This means that if the spinal cord gets injured, the
brain can no longer send messages past the part of the body where the spinal
cord got injured. If this is the part of the spinal cord that sends messages to
your hands, this could mean losing functionality to grip and grasp objects.
Typically the higher up on the spinal cord that the injury occurs, the more
dysfunction the person will experience.

For example, if someone has an injury at the cervical 5-8 level (C5-C8) they
will usually be able to move their shoulders and elbows but could have
difficulties moving their wrists and fingers. This could lead to the inability
to use the hands for simple tasks that are part of daily living. Not being able
to control hand movement can get very frustrating because it can take away
independence.

Wearable hand robot for spinal cord injury
Luckily, Neofect [https://www.neofect.com/en/] has a created a robotic assistive
device called NeoMano that helps with hand motions in order to give people back
their hand function and independence. NeoMano is a wearable robot hand glove
[https://neomano.neofect.com/] that assists with the grasp and release of
objects. The glove is a partial-glove design that enables the thumb, pointer and
middle finger to perform grasp and release motions. NeoMano can assist people
with everyday tasks such as feeding, writing, exercising, and daily grooming
tasks. People have even rediscovered old hobbies with the use of NeoMano, like
golfing and photography!



To learn more about NeoMano please visit neomano.neofect.com
[http://neomano.neofect.com]. Don’t forget to share with your friends or family
that would find NeoMano interesting or useful!