SPINAL CORD INJURY 185
EARLY PHYSICAL RE-EDUCATION
The goal for a spinal cord injured person is to become as independent as possible in
doing what he or she wants and needs to do. But even before the skills of daily living
are relearned, the person needs to learn to protect the body where functions that
used to be automatic have been lost. The protective functions that may be lost or
changed include:
1. Adjustment of blood pressure to changes in body position.
2. Feeling (including pain) that protects from injuries (such as bed sores).
3. Sense of body position and ability to keep balance.
4. Muscle strength and coordination.
5. Control of body temperature—especially keeping cool in hot weather.
1. A sudden drop of blood pressure in the brain when the person rises from lying
to sitting, or sitting to standing, can cause dizziness or fainting. This is a common
problem in spinal cord injury because the blood pressure adjustment mechanism
is partly lost. Little by little the body can be helped to re-adapt, but precautions are
needed. (These same precautions are for anyone who has been kept lying down a
long time.)
Before beginning to sit,
raise the head of the bed
–a little more and a little
longer each day.
Lifting exercises
help the body
relearn to adjust
blood pressure–
and also prevent
bed sores and
strengthen arms.
Before beginning to
stand, make a standing
board, and strap the
child to it. Start at a low
angle, and stand the
board up more—and
longer—each day.
Start like this
for 15 minutes.
In a week or 2 build up
to this for 3 hours.
If the person begins to
get dizzy or faint when
sitting, tilt him back
and lift his feet.
2. The loss of feeling in parts of the body can lead to pressure sores and other injuries,
such as burns and cuts. This is because the body no longer feels pain and does not warn
the child to change position or move away from danger.
It is important that the child learn to protect himself by changing positions often
and avoiding injuries. This includes:
• examining the
whole body every
day for signs of
injuries or sores
• washing
daily
• learning to protect himself
from burns and other injuries.
For example,
• learning to
roll over
• turning at least
every 4 hours
when lying or
sleeping
• lifting from sitting
every 15 minutes
(see p. 198)
NO! NO!
DO NOT sit on or
touch hot objects
(or roads).
DO NOT sit, lie
or sleep near an
open fire.
disabled village children