Spinal cord injury treatment, research, and hope for recovery.
Spinal cord injury treatment, research, and hope for recovery.
The Man in Motion World Tour celebrates its 20th anniversary in 2007. This marks Rick Hansen’s return to Canada for the final leg of his historic “wheel around the world” that created awareness and funds for people with spinal cord injuries.
Rick propelled himself the equivalent of the earth’s circumference between March 21, 1985, and May 22, 1987. Publicity and financial support increased exponentially when his tour arrived on Canada’s east coast on August 24, 1986, to begin the cross-country journey westward to Vancouver, where it had started. To Rick’s surprise, there was a welcome home sign indicating that this was not the end, but just the beginning.
Rick can be proud of his accomplishments over the subsequent two decades, which include: the generation, through his foundation, of over $178 million for spinal cord injury (SCI) initiatives; global and research awareness of spinal cord injury (90 per cent of what we know about SCI was learned during this time); establishment of the Spinal Cord Injury Translation Research Network (SCI-TRN); and the partnering with the International Collaboration On Repair Discoveries (ICORD) centre in Vancouver.
The intent of the Man in Motion tour continues today through the annual community-based Wheels in Motion events that take place the second Sunday in June in more than 200 Canadian towns and cities.
The chiropractic profession benefited directly from Rick’s legacy when researcher Dr. Jean-Sébastien Blouin received an operating grant from the B.C. Neurotrauma Fund, in collaboration with the Rick Hansen Foundation.
THE CHIROPRACTIC CONNECTION
As chiropractors, we can take pride in our involvement with Rick Hansen’s initiatives right from the beginning. I first met Rick when he came into my office as a patient on January 22, 1985. Then new in practice but connected with provincial and alumni associations, I wholeheartedly backed Rick’s aims and helped to build chiropractor and patient support for his world tour.
Chiropractic newsletters disseminated information that helped raise money, and Rick received letters of endorsement from our provincial and national associations as well as from chiropractic college leaders. Rick received chiropractic care before starting out, and arrangements were made directly with the tour’s support staff for Rick to see chiropractors at specified locations across the nation. To this date, Rick continues to seek chiropractic care.
When you meet Rick Hansen, you find him to be a sincere, enthusiastic, focused and goal-oriented individual. Though passionate about his pursuits, he is very grounded and down-to-earth in his ways. He has the knack of helping people look deep inside themselves to examine their own fears and perceived disabilities, and he provides inspiration to find strength to overcome them and carry on.
Having worked with Rick as a patient and also having treated others with spinal cord injuries, I believe that chiropractors are much underutilized in this field of care.
POST-INJURY CHALLENGES
Most of us take the use of our limbs and spine for granted, that is until we experience a problem with them, or worse, lose their use. With post-injury motivation to keep going, and an ability to compensate for a particular physical disability, we unavoidably put unusual and unexpected stress on the body. Resulting tissue strain, nerve irritation, pain and dysfunction, along with gait or mobility alterations, further affect the person’s quality of life. Add wheelchairs, crutches, splints, and accessibility issues, and you are indeed confronted with some challenges.
Skilled in the detection of blockages to good body alignment, proper function and feeling well, chiropractors possess the means to help correct, remove or improve upon these barriers. Indivi-duals with SCI need our services, and we should feel comfortable working with them.
Here is an interesting story. A paralympian who comes to see me whenever he perceives his pelvis to be misaligned has no actual feeling below his mid-back level. However, he does experience signs of urinary frequency and generalized skeletal muscle contractures, probably due to associated autonomic nervous system irritation. Restoration of pelvic interarticular joint function helps him return to normal. An interesting side note is that problems arising from autonomic nervous system dysfunction are the leading causes of secondary complications. If the SCI person’s bladder is full, the message doesn’t get through and the body overreacts. Potentially lethal consequences can then occur, including elevated blood pressure and heart rate, bladder infection, septic shock, and death (In Motion Newsletter, Fall 2006).
Do you not think that we chiropractors have something to offer here?
THE NATURE OF THE INJURY
The spinal cord consists of millions of nerve fibres that relay sensory and motor messages between the brain and the body as it travels through the inside of the spinal column. An interruption of those messages takes place when the spinal cord is injured by traumatic forces, disease or certain congenital disorders. This may result in partial or complete weakness or paralysis.
Spinal cord injuries affect each person differently because the spinal cord is usually not damaged in exactly the same way in any two individuals. The severity of the paralysis is determined by the extent of damage to the spinal cord. Depending on the site of the assault to the spinal cord, a person will manifest weakness or paralysis, to some degree, in the lower body and legs (paraplegia) or weakness or paralysis, to some degree, in all legs and arms (quadriplegia).
Spinal cord injury can be complete or incomplete. In complete spinal cord injury, there is no voluntary movement or sensation below the level of the injury. In incomplete spinal cord injury, there is some sparing of sensation or voluntary movement. Respiratory, bowel, bladder and sexual dysfunction may occur.
Paraplegia is the paralysis of the lower extremities and part or all of the trunk muscles. Usually there is a loss of sensation in paralyzed limbs as well as other effects such as muscle spasms, pain and loss of bowel and bladder control. Paraplegia occurs when there is impairment at or below the T1 thoracic level.
Quadriplegia occurs when there is damage to the spinal cord in the cervical region, adding impairment to the hands and arms to the effects of paraplegia.
Hemiplegia is the paralysis of one side of the body as a result of a stroke or traumatic brain injury, not to be confused with paraplegia or quadriplegia. With paraplegia and quadriplegia, the brain is not affected.
With hemiplegia, there may be an impairment of intellect, personality, speech or senses.
Damage to the spinal cord due to an injury can be permanent, and currently there is no cure. However, new research proves that spinal cord repair and regeneration is possible. More and more researchers around the world are confident that a cure for paralysis is imminent. In addition, new breakthroughs and discoveries are helping people to better manage quality of life issues associated with spinal cord injury, such as chronic pain, bladder, bowel and sexual dysfunction, and increased susceptibility to respiratory problems.
TREATING SCI PATIENTS
In order to treat patients with spinal cord injury, your office must be wheelchair-accessible. Various agencies can help with these necessary requirements.
The challenge for a chiropractor will be the positioning of the patient in order to provide treatment.
Many SCI patients who elect to see you will likely be paraplegic, as they have a greater degree of independence. These individuals are usually able to sit to some degree, and they have enough strength in their arms to help transfer themselves from their chair to your table. Many will use a transfer or sliding board to assist with this action. Proper positioning of their wheelchair, along with locking of their wheelchair brakes and positioning of footrests, will assist in an easier and more comfortable transfer.
Most patients will have some degree of abdominal/core muscle impairment, so stability out of their chair is compromised. It is helpful to assist the patient transfer by holding and carrying his/her legs, making sure you help support the patient on your treatment table after transfer.
Side posture positioning requires extra awareness of the legs, as they will easily get away from you if not stabilized. Uncontrolled muscle spasm, common during patient positioning, will quickly abate on its own. Be aware of locking knee devices, and bladder and colostomy bags.
QUALITY OF LIFE
I hope you will consider ways of assisting the Wheels in Motion awareness-heightening campaign to enhance the quality of life of people with spinal cord injury. You can donate money, help organize an event or participate in one. Most significantly, of course, as chiropractors you can expertly treat those with spinal cord injury in your offices.
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