While around 500,000 people suffer from spinal cord injury around the world each year, those affected by the disability in the UAE are mainly caused by road accidents and falls.
“Most spinal cord injuries are caused by road traffic accidents, violence, contact sports or falls. In the UAE, the main causes are road traffic accidents and falls,” said Dr Vaqas Farooqi, consultant of physical medicine and rehabilitation, Amana Healthcare, Abu Dhabi.
He explained that patients suffering from spinal cord injury may develop tetraplegia, (weakness in arms and legs), or paraplegia, (weakness in legs).
“Both cause difficulty in getting up and walking. Several neurological functions are affected as well, such as control of bowel and bladder, maintenance of joint range, and regulation of blood pressure and temperature.”
He stressed that in higher level injuries, breathing may be compromised and require ongoing supported ventilation.
“Traumatic injuries are commonly associated with ‘silent’ symptoms such as emotional and psychological disturbances, including depression and anxiety. Many patients may also exhibit behavioural changes and cognitive issues, including being unable to remember or process information.”
He said these effects can sometimes be even more significant than the physical disability. “It’s important to ensure they receive proper care and rehabilitation as soon as possible after the originating injury.”
Rehabilitation involves a range clinical disciplines such as physiotherapy, occupational therapy, speech therapy, clinical psychology and neuropsychology, exercise physiology, social work and vocational and recreational therapy.
“The road to recovery may be long and challenging. But with rehabilitation, support from family and friends, and most importantly, determination, overcoming spinal cord injury and regaining quality of life is a real possibility,” added Dr Farooqi.
Some may not recover ?completely
Srividya Iyer, specialist – physiotherapy, Burjeel Hospital, said it can take months or even years for a patient to recover from a spinal cord injury, yet not all patients will recover.
“Rehabilitation is key to maximising the chance of recovery and gaining the patient’s movements and senses back. But patients may never have a complete recovery, because if there is a path of the cord injured, there may not be complete regeneration, so they might be left with residual deficits,” she added.
The physiotherapy specialist pointed out that the complex disorder in the neurological system involves motor and sensory functions.
She said the rehabilitation can, however, work on various aspects. “Rehab can start from the time of the ICU and can range from passive to a more active form of rehabilitation, which involves bed mobility exercises.”
She said insuring patients have access to continuous treatment is crucial, as it may help them regain functions and movements, which can be life-changing on the suffering individual.
“We have to make them as functionally dependent as possible. These include strengthening exercises, exercises in bed, making the patient sit, stand, as well as using devices that help the patient with movement.”
She noted that apart from traditional treatments, there are also modern therapies that help patients work with a therapist in the water. “Weight off-loading devices are important in this – there are also advanced robotic devices for upper and lower limbs.”
More importantly, she stressed that for the spinal cord of the brain to recover, a high repetition of exercises are vital.
“With a computer assistant technique or the robotic technique, one can do a lot of repetitions of movement and can engage the patient.” Iyer added that she has seen eight spinal cord injury cases this year alone.
“The patients also need be counselled, because living a normal and healthy life, then suddenly loosing movement and senses due to an accident can be traumatising.”