Rehabilitation after Spinal Injuries in Patients 45+

What Are Spinal Injuries

Spinal injuries are among the most serious injuries to the musculoskeletal system of the human body. Unlike damage to other bone structures, where the main task is to restore the integrity of bones in order to normalize the functions of support and movement, spinal injuries are closely related to the human nervous activity. This is because the spinal canal contains the spinal canal, an organ of the central nervous system that provides communication between the brain and the periphery and carries out segmental reflex activity. The brain can be compared to the computer’s processor, and the spinal cord is like the peripheral devices that execute its commands. Very often, spinal injuries are accompanied not only by violations of the integrity of the vertebrae and intervertebral discs but also by damage to the spinal cord, which can affect a variety of body functions. Patients may experience weakness, lack of coordination, numbness of the limbs. Severe consequences of spinal injuries include paralysis anywhere in the body, loss of sensation in the hands, fingers, feet, or toes, and loss of bowel or bladder control.

The most common causes of back injuries that injure the vertebral column and spinal cord are road travel, falls with a bad landing and high back impact, and head-down diving in unexplored water. The latter type of injury is one of the most severe: when hitting the bottom, the spinal cord is damaged in the cervical spine and, as a rule, the diver is paralyzed below the neck level. That is why any injury to the spinal column requires immediate medical attention.

Spinal injuries, in which the spinal cord is involved, in most cases, require not only highly qualified surgical treatment but also a fairly long rehabilitation.

Rehabilitation in People over 45 Years Old

Persistent and methodical rehabilitation is especially important for patients in the 45+ age group. At this age, the process of regeneration of nerve structures begins to slow down, and for recovery, it is necessary to follow all the advice of a rehabilitation doctor. The operation is responsible for only 60% of the success of treatment, the rest depends on a well-designed and carefully followed rehabilitation program. Why does the operation not give a complete result? The fact is that it is extremely rare that it is carried out as quickly as possible, immediately after the injury. In addition, even a few hours elapsed between the injury and the operation may be enough for a violation of blood supply and innervation in muscle fibers to lead to metabolic disorders in them. As a result, muscle hypotrophy develops, the lower extremities are especially severely affected. The functions of leg extension and dorsiflexion of the foot are inhibited, hip abduction becomes difficult. The gluteal muscles, muscles of the thigh, and lower leg are also threatened by malnutrition.

Even if the spinal cord injury is isolated and uncomplicated, in order to exclude or minimize the likelihood of complications, the course of rehabilitation should not be neglected. The rehabilitation program is best done in a specialized center, where the physician can prescribe the most effective recovery course. Rehabilitation at home is highly undesirable since the patient must be under constant medical supervision. At home, even the most responsible patients cannot achieve optimal results, since they don’t have the necessary equipment for rehabilitation (simulators, supporting devices) at their disposal, and there is no one to control and correct their actions, assess the correctness of the exercises and mark their progress.

Main Rehabilitation Phases

Rehabilitation programs differ depending on how long ago the patient had the trauma.

1. At the early stage of rehabilitation in patients aged 45+, the main task is the gradual verticalization and activation of the patient using a special verticalized, as well as passive and breathing exercises. During individual lessons with an instructor-methodologist, the patient receives a massage of the muscles of the limbs and paravertebral muscles to prepare for independent walking or getting into a wheelchair.
   Also, at the early stage of rehabilitation after severe spinal injuries, special attention is paid to teaching the patient to properly drain urine under the supervision of a neuro-urologist. This is a very important aspect of rehabilitation, as it avoids secondary infectious complications from the urinary system. According to Medical News Today, it also helps to normalize the patient’s psychological state.
2. At the next stage of rehabilitation after injuries of the spinal cord and spine, the complex of therapeutic exercises is expanded. Patients are assigned classes in the pool, especially useful for people over 45 years old. To restore motor functions, mechanotherapy is used to train the walking function (for example, using the Lokomat, Geo System), the patient is activated in a special exoskeleton (Exoatlet). Also at this stage, it is advisable to carry out therapy for targeted training of the motor function of the limbs (Thera-trainer, Motomed).
3. At the later stage of rehabilitation treatment, the treatment program includes physiotherapy and balneotherapy.
   Good results are shown by the use of electro microstimulation of the extremities, low-intensity laser therapy to improve microcirculation, prevent the development of contractures and reduce pain. Balneological procedures include local and general hydromassage baths, mineral baths, mud, and paraffin applications to reduce muscle spasticity, improve the trophic state of the skin, as well as to influence the central nervous structures.
4. In the late period of rehabilitation (3 months after injury), it is important to develop atrophied muscles and restore range of motion in the joints.

A well-chosen diet plays a big role in achieving optimal results. Foods containing unhealthy fats are excluded from the diet; emphasis is placed on cottage cheese, vegetable fiber, foods rich in collagen and protein (jellied meat, lean meat, fish). The level of vitamin D deficiency is imperative. If the patient does not have the opportunity to regularly be in the sun, you can compensate for the lack of sunlight with fish oil.

Benefits of Undergoing Rehabilitation after Spinal Injuries in 45+ Patients in a Specialized Center

In a rehabilitation center, rehabilitation programs are drawn up by specialists with medical licenses individually for each person in accordance with US Healthcare standards.

Clinical recommendations for the passage of such programs are given from the first day after the main treatment, including after a recent operation. Each case requires a professional combination of procedures and physical rehabilitation systems. It is dangerous to select exercises, types of load, and other means of recovery on your own since there is a high risk of aggravating your condition, provoking the development of complications. In addition, in order to achieve positive dynamics of recovery, it is important to observe the sequence and regularity of all necessary manipulations. Rehabilitation of patients over 45 years old includes the assistance of a neurologist, therapist, physiotherapist, physiotherapy specialist, urologist, surgeon, and psychologist.

Rehabilitation doesn’t stop after the patient leaves the clinic or care center. Self-rehabilitation shall go on later. Find more info about it here: https://healthcare.utah.edu/neilsen-physical-rehab-hospital/specialties/sci-spinal-cord-injury/yes-you-can.pdf