Quadriplegia Physiotherapy Treatment
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What is a quadriplegia?
Quadriplegia, also known as Tetraplegia, is defined as paralysis caused by illness or injury to a human that results in the partial or total loss of use of all their limbs and torso; paraplegia is similar but does not affect the arms. The loss is usually sensory and motor, which means that both sensation and control are lost. Tetraparesis or quadriparesis, on the other hand, means muscle weakness affecting all four limbs.
Causes of Quadriplegia or Tetraplegia
Quadriplegia or Tetraplegia is commonly caused by any injury or trauma to the spinal cord. Some of the common causes of this are:
- Trauma or injury to the neck such as being involved in a car or sports accident resulting in a broken neck or fracture of the cervical vertebrae.
- Tumor in the spinal canal may also cause quadriplegia.
- Other medical conditions in the spinal cord may also result in quadriplegia.
- Certain diseases like polio, transverse myelitis, and spina bifida.
Signs and Symptoms of Quadriplegia or Tetraplegia
The severity of the paralysis depends on the location of the trauma/injury. Injuries occurring in the higher region of the spinal cord, i.e. the neck, resulting in more severe paralysis. Injury at the neck level of the spinal may result in both the arms and legs getting paralyzed. Patients suffering from this kind of paralysis cannot breathe without a respirator. If the injury is to the lower part of the spine, then only the legs and lower parts of the body may get paralyzed. Symptoms consist of:
- Bowel and bladder incontinence.
- Sexual dysfunction.
- Impaired digestion.
- Difficulty breathing.
- Patient experiences numbness and decreased sensation.
- A patient may also experience burning neuropathic pain.
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Treatment of Quadriplegia or Tetraplegia
Treatment of quadriplegia depends on the severity of the condition and it also depends on the particular needs of the patient. Treatment is directed at addressing the patient’s loss of functioning and sensation in the paralyzed regions of the body and also loss or impairment in any functioning of the organ.
- If the cause is bruising or swelling of the spinal cord, the nerves may start functioning again. Steroids are given to prevent and reduce any swelling of the spinal cord.
- If the cause is an injury, then emergent treatment is required so that further damage to the spine is prevented.
- There is no treatment which can reverse this condition. Surgery can only help so much and when done immediately after the injury, it can help in supporting and stabilizing the spinal vertebrae and bones.
- In case of fracture, the bones or discs compress the spinal cord and surgery helps in relieving this pressure and in removing the bone fragments and realigning the bones.
- If the patient is taken to rehabilitation regularly and with more surgeries, the condition of the patient can be improved. Partial movement can be gained for patients with operable quadriplegia by employing screws, metal rods, bones, muscle, and tissue from other regions of the body.
- Functional electrical stimulation also helps in providing partial movement to the paralyzed muscles.
- Patients with injuries to the higher vertebrae or nerve segments, i.e. C-1, C-2, C-3, need a ventilator to help them breathe. Alternatively, a phrenic nerve pacer can be placed surgically to help the patients in breathing. It transmits electrical impulses to stimulate the diaphragm.
- Ongoing care involves treating the pressure sores which quadriplegic patients suffer from due to constantly being at one place and these sore require proper wound care with debridement of the necrotic tissue.
- Nutrition is very important in quadriplegic patients.
- Quadriplegic or tetraplegic patients need a constant caregiver to help them take care of their personal hygiene, cleanliness and also to take them to various physicians such as neurologists, physical therapists, occupational therapists, respiratory therapists, speech pathologists, and psychologists.
- Patients may also need to wear body braces according to their injuries, as their vertebrae would be damaged and they need to be stabilized.
- Physical therapy for the patient is extremely important in order to keep their muscles strong and active.