Irreversable?

[Wise Young]

Originally Posted by havok

So I was viewing a video that mentions that even if a fix could be found for SCIs in the future, all of us who have sustained it years before the break through will still gain no benefit from it. The muscles go into fibrosis and it is irreversable? Is this true and if so is hope for chronic SCIs gone?

reference at 12:30 of linked video
http://youtu.be/HZ50nCACGq4

havok,

I watched this video. It is mostly about peripheral nerve injuries. What this doctor describes may happen to people with peripheral nerve injuries and muscle injury, who do not receive adequate physical therapy. This does not usually happen to most people with spinal cord injury. Muscle fibrosis can occur in spinal cord injury but it is preventable.

If a person has had paralysis for a long time and does move the muscles for months, the muscles can indeed undergo fibrosis. However, movement and stretching of the muscles will prevent such fibrosis from happening. People must move their legs and muscles every day, so that they do not go into flexion contracture. Once flexion contracture and fibrosis has occurred, intensive physical therapy is required to stretch out the muscles. Surgery may be necessary to extend the muscles.

People must also keep their bones and joints from undergoing similar atrophy. Note that many studies have failed to show change in bone calcium levels after weeks or even months of weight-bearing but most of these studies have people standing only one hour a day, 3 days a week. To reverse severe osteoporosis, weight-bearing for several hours a day, 6 days a week, and for many months may be necessary.

Some people may have muscle fibrosis from decades ago when the standard of care for spinal cord injury care did not include physical therapy or exercise of people after spinal cord injury. I disagree with doctors who discourage patients from weight-bearing and even tell them the there is no need for them to do so because they will never walk again anyway. These should no longer happen these days with more enlightened care of spinal cord injury.

Wise.

[lakboy]

What exactly do you mean by weight bearing ? This has me in a fix , I stand in my calipers for some times upto 4 hours a day , but the weight is taken by the calipers , so how am i doing weight bearing , since all the weight is taken by the calipers. please be more specific !

[2TiRods]

Originally Posted by lakboy

What exactly do you mean by weight bearing ? This has me in a fix , I stand in my calipers for some times upto 4 hours a day , but the weight is taken by the calipers , so how am i doing weight bearing , since all the weight is taken by the calipers. please be more specific !

Standing with calipers or KAFOs is still weight bearing. These only keep your knees locked, they don't suspend you.

[alan]

People will still have scoliosis, osteoporosis, any changes in bladder that neurogenic bladder can cause, etc. to deal with, even if a 100% cord-regenerating cure is found. Plus, if it is true that chronic pain becomes imprinted in the brain, that will remain, and require a treatment.

[jody]

my adopted granda, had a fused hip injury when he was very young, and when he was about 68, he got a hip replacement. This was in the early eighties when hip replacements were just getting really successful. He had no muscle on his behind on that side, and none in the leg. The found nerves were encapsulated by bone, so cleaned and exposed what they could. Once he was able to move, he gained muscle in that leg, and his range of motion got better as he gained muscle.

I hope contracted muscles can be helped. and Im really hoping that once the nerves are firing and getting feedback, that the neuro pain might go away.

[Wise Young]

Originally Posted by lakboy

What exactly do you mean by weight bearing ? This has me in a fix , I stand in my calipers for some times upto 4 hours a day , but the weight is taken by the calipers , so how am i doing weight bearing , since all the weight is taken by the calipers. please be more specific !

I agree with 2TiRods. Standing in calipers is weight-bearing. Wise.

[Finbar]

Wise,
What about Decorin? Is there a medicine that can help with fibrosis and extreme spasticity?
Finbar