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Thread: When someone suddenly regains a trace movement in a paralysed muscle, how to proceed?

  1. #1

    When someone suddenly regains a trace movement in a paralysed muscle, how to proceed?

    Hey, need some advice:

    My dad began his paralysed journey as a C5 B. Because of the lack of pin prick sensation below C7, they told him that once he regained movement as far as C7, that was it. Finished. Welcome to the rest of your life, you're screwed, get used to it and don't reach for anything further.

    I could rant for hours about how destructive the attitude instilled in newly paralysed patients by pessimistic medical folk is to chances of recovery, by de-motivating the patient from throwing themselves into their physio etc - but I'm pretty sure we're all singing from the same hymn sheet here on that one already.

    It's nearly two years after his injury (Two years on June 3) and he has regained a huge amount of movement below the injury level. He can now wiggle his toes, bend his ankle muscles back and forth, kick his legs slightly while in a sitting position, and either close or open his legs - I'll have to ask him to remind me, but basically whichever one of those he can do, he can't do the opposite, so if he's able to open his legs at the hips, he needs someone else to push them together - or it could be that he can close them on his own, but needs someone to open them in the first place.

    Regardless, he's just developed a new movement out of nowhere - for the last couple of weeks, he's been able to raise his knees when he's in a lying position. Meaning that if he's lying down in bed, he can raise both of his knees very slightly so as to create a small triangular space below them - in other words, raise the knee off the bed and draw his heel towards his abdomen.

    Now, he can only do this in a trace movement at the moment, and it takes literally all of his concentration and exertion - judging by his body language, he puts about as much energy into doing just one rep of this movement as an able-bodied person would put into lifting an 80kg barbell. So when I say "trace" movement, I really do mean trace. I'm no expert, but I'd rate it as maybe 1 or 2 on the 5 point ASIA scale for muscle mobility.

    My question is: Now that he has regained these muscles and therefore obviously "rewired" them in his brain and spinal cord somewhat, what's the next step exercise and physio wise? I know for a fact that once there's even the slightest hint of voluntary movement there, exercise, physio etc will most likely make the difference between this staying as-is as a party trick, or progressing further into useful, potentially life-changing improvement of paralysis. But I'm a bit lost as to where to start.

    For example: Should he be trying to do a bunch of short repititions of this movement at a time - or is it more beneficial to lift the knee and then try to hold it in that position for as long as possible (the difference between doing sit-ups and planking, essentially)? We have a neurotrac FES device - should we be using this on those specific muscles? Is there anything people can advise in terms of how to harness trace voluntary movements in paralysed limbs, to at least give them the chance to realise their full potential in terms of movement returning?

    I know a medical person will always say "manage your expectations, trace movement is pretty meaningless, blah blah blah" but I'm sure most here will understand that seeing voluntary movement so far from the site of injury is impossible not to take as a massively exciting and hopeful sign. My biggest fear is that the "nothing to see here, really, you're still screwed" attitude of medical folk will cause my dad to ignore this opportunity - perhaps ignore it until it's too late to capitalise on it.

    So I'm basically looking to bypass his consultant on this and devise a workout and exercise program for him and his care team, who do a bit of physio under instruction from him, to work with.

    Any advice whatsoever would be greatly appreciated. Exercise, types of exercise, FES, whatever - open to any and all suggestions.

    Thanks in advance to anyone who's able to give us a hand with this!

  2. #2
    Concerned Son,
    It is possible for someone to regain function 1-2 years after an injury, it all depends on how the spinal cord was injured initially. If it was an incomplete injury (i.e. bruising of the cord or release of pressure placed on it) this is a possibility.

    I would recommend to you and your father to consult a physiatrist (a doctor who specialized in rehabilitation medicine) and then in turn a physical therapist familiar with spinal cord injuries. You can then plan a course of therapy to maximize his abilities.

    Best wishes to you both. Keep us posted.

    pbr
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
    Senior Member Wills77's Avatar
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    He could be raising them with his lower abs or hip flexors. Laying flat I can't bring my knees up like you explained but a workout I do is.. lay on my back with my butt right at the edge of the bed and my feet on the floor, then I grab my right leg and pull it up towards my chest, this really stretches my left hip flexor. While still pulling my right leg/knee towards my chest I am able to lift my left leg up using what movement I have. Sometimes I will do as many fast reps as I can until it doesn't move at all. Sometimes I try to hold it for 3 seconds at the top of each rep. Then I switch legs and do it again.

    I'm a c6 ais C Just hit the 7 year mark and noticed new movement in my ankle 2 weeks ago. I've continued to regain function after the 2 year mark
    c6 inc since 2-19-11
    ex pro-am motocross racer
    tilite aero z s2

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