Home exercise programs are particularly important for people with spinal cord injury, 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 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 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, 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 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.
TOOLS TO MAKE HOME EXERCISE FUN
Neofect Smart Board
People with spinal cord injury can be particularly impacted by tight pectoralis (chest) muscles. Tight chest muscles limit the movement of the shoulder, and in turn affect a person’s ability to participate in daily activities, such as putting their clothes on or grooming/hygiene tasks.
The Neofect Smart Board targets the muscles of the shoulder and elbow, which helps maintain range of motion and strengthen with each repetition.
Neofect Smart Glove
Depending on the level of injury, people with spinal cord injury may also benefit from strengthening the movement of the forearm, wrist, and fingers to increase their ability to hold an object, such as a utensil to feed themselves.
By using the Neofect Smart Glove you can strengthen the muscles of the forearm, wrist, and fingers. Strength is all about repetition and resistance. Gravity can be your resistance until you’re ready to add weights. With the Neofect products, you won’t even know you’re doing exercise.
WHY IT’S IMPORTANT TO MAKE IT FUN
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.
One of the main reasons it’s hard to be consistent with home exercise is motivation. The Smart Board and the Smart Glove utilize gamification to create a fun and motivating way to be consistent with a home exercise program.
The Smart Board and the Smart Glove not only provide visual biofeedback for motivating movement, but moving a joint for a functional activity is more effective than isolated muscle strengthening.
The Smart Board and Smart Glove provide range of motion measurements and measures your timing and coordination. You can see your progress, which provides patients with concrete feedback and improves motivation for consistency. It also allows you to set a long term functional goal that helps keep your eye on the “why” the exercises are important. 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.
If you have had a stroke and are looking for an effective solution for your rehabilitation needs, please look into Neofect's line of Smart Rehabilitation Solutions.
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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.