Home exercise programs are important for a spinal cord injury to increase function and maximize recovery and also to prevent further physical limitations.

Home Exercise is Important After Spinal Cord Injury 



Home exercise programs are particularly important for people with spinal cord
injury [https://www.shepherd.org/patient-programs/spinal-cord-injury/about], not
only to increase function and maximize recovery, but to prevent further physical
limitations.

While spinal cord injuries are non-progressive, patients are likely to
experience muscle atrophy or develop joint contractures
[https://www.neofect.com/us/blog/how-do-i-prevent-hand-contracture-after-a-stroke] 
from poor positioning, lack of movement, and muscle tightness. People with
spinal cord injury are also at high risk for cardiovascular disease.



Home exercise programs should be tailored to a patient’s individual needs, as
there are many individual factors that affect participation and optimal
outcomes. A physical or occupational therapist can assist with customization,
but home programs should include cardiovascular exercises, exercises to maintain
range of motion, and muscle strengthening.

Cardiovascular Exercise


Cardiovascular exercise
[http://sci.washington.edu/info/forums/reports/exercise_2013.asp] involves
increasing the heart rate and rate of breathing. Cardiovascular exercise
improves the way the heart and lungs function. Depending on the level of injury
there are many ways to accomplish this using just the upper body, including:
pushing a wheelchair, using an arm bicycle, seated aerobics, rowing, and Wii or
Kinect video games (boxing, dancing, etc). You just gotta get that heart
pumping!

Make sure to check in with your physician before starting an exercise program.
Of particular note: people with spinal cord injuries at or above the T6 level
are at risk for autonomic dysreflexia
[https://www.christopherreeve.org/living-with-paralysis/health/secondary-conditions/autonomic-dysreflexia]
, which is simply the body’s protective responses going into overdrive which can
have serious consequences if intervention is not given rapidly. Prior to
starting an exercise program, patients should be aware of their baseline blood
pressure and the symptoms of autonomic dysreflexia.

Maintaining Range of Motion


Passive range of motion is needed to maintain movement in a joint. If you don’t
move it, you lose it! Think of the movement like opening and closing a door.
Each time you move the joint, it’s like putting oil on the hinge of a door. If
you don’t ever open the door, the hinge will get rusty and you won’t be able to
open the door easily. We want to keep as much joint mobility as possible because
tight joints make getting dressed and showering much more difficult.

Depending on the level of injury and whether a spinal cord injury is complete or
incomplete will determine which joints need to be passively moved through their
range of motion. This can be done by either the patient or caregiver.

Strengthening


Strengthening of a muscle happens with repetitions of muscle contractions to the
point of fatiguing the muscle. Think of a person at the gym doing a bicep curl.
To build strength you need to use enough weight that the muscle is fatigued
after 10-15 repetitions of movement. Typically for strengthening you would
complete 3 sets of 10-15 repetitions with 1-2 minutes of rest between each set.
To build endurance, you would use a lower weight and complete 3 sets but
increase the number of repetitions to 20 or 30 with shorter rest breaks between
sets.

Even if you’re not using weights, simply activating that muscle and moving
through the range of motion using the same parameters will build strength. The
other important thing to consider is gravity. It makes a huge difference! If a
person is able to activate a muscle, but cannot move against gravity, they can
try repositioning their body at a different angle that takes gravity out of the
equation. Once they gain strength in a gravity eliminated plane, they can
progress to against gravity, then light weights, then slowly increase the
weight.

The other way to strengthen is by participating in your daily activities to
whatever extent you are able. Everytime you push your arm through the sleeve of
your shirt you are activating your tricep muscles. Everytime you eat and bring
your hand to your mouth, you’re activating your bicep muscles. It’s a balance of
allowing someone to assist and taking on as much as you are physically able.

Staying Engaged in Exercise
Finding motivation to complete a home exercise program is a universal problem
throughout rehabilitation, and yet it’s so important! It’s impossible to gain
strength in the 1-2x a week session a patient is seen for OT or PT. To combat
this, make sure your exercise program is tailored to your interests. Involve
friends and family who will follow along with your progress and hold you
accountable.

Ultimatelly, maintaining motivation is worth more than just a physical payoff
the long run. It’s not just about strengthening, it’s about finding what
activities matter to you. It’s the meaningful activities we do everyday that
improve our quality of life.

All content provided on this blog is for informational purposes only and is not
intended to be a substitute for professional medical advice, diagnosis, or
treatment. Always seek the advice of your physician or other qualified health
provider with any questions you may have regarding a medical condition. If you
think you may have a medical emergency, call your doctor or 911 immediately.
Reliance on any information provided by the Neofect website
[https://www.neofect.com/us/for-home] is solely at your own risk.