GIGER MD® Therapy
Injury Complications

Injury Complications

After spinal cord injury, many aspects of life change. A wheelchair can be isolating. Attitudes of others are very important in accepting the person as an individual, rather than the occupier of a wheelchair.

When damage to the spinal cord is a result of an accident, this sudden onset usually produces considerable psychological trauma as well as secondary physical diseases.

 Skin Breakdown: Skin breakdowns (also termed “decubitus ulcers” or “pressure sores”) are a major complicationassociated with spinal cord injury. They occur as a result of excessive pressure, primarily over the bones of the buttock (particularly the ischial tuberosities and the trochanters at the hip). Following a spinal cord injury, there are not only changes in muscle tone and sensation, but shifts in the supply of blood to the skin and subcutaneous tissues. Additionally, there is a loss of the normal elastic nature of the tissues underlying the skin. Increased stiffness, vascular alterations and alterations in muscle tone combine to significantly reduce the skin’s ability to withstand pressure.

Osteoporosis and Fractures: Osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These brokenbones, also known as fractures, occur typically in the hip, spine, and wrist.The majority of people with spinal cord injury develop osteoporosis. In people without spinal cord injury, the bonesare kept strong through regular muscle activity or by bearing weight. When muscle activity is decreased or eliminated and the legs no longer bear the body’s weight, they begin to lose calcium and phosphorus and become weak and brittle. It generally takes some time for osteoporosis to occur. In people who use the GIGER MD® Instruments, osteoporosis is not of a problem.

Unfortunately, at the present time, there is no way to reverse osteoporosis once it has occurred. The main risk of osteoporosis is fracture. Once the bones become brittle, they fracture easily. An osteoporotic bone takes much longer to heal.

Pneumonia, Atelectasis, Aspiration: Patients with spinal cord injuries above the T4 level of injury are at risk to develop restriction in respiratory function, termed restrictive lung disease. This occurs five to 10 years following spinal cord injury and can be progressive in nature. The quadriplegic individual as part of a health care maintenance routine should have pulmonary function studies at yearly or every-other-year intervals between five and 10 years post injury. As the medical treatment of spinal cord-injured individuals continues to improve, respiratory complications of SCI are becoming more prominent. Adequate health maintenance and protection from this complication are appropriate and necessary as part of the long-term care of the spinal cord-injured individual.

 

Heterotopic Ossification: Heterotopic ossification is a condition not well understood that occurs in acute spinal cord injury and consists of the laying down of bone outside the normal skeleton, usually occurring at large joints such as the hips or knees. The primary problem with heterotopic ossification (HO), is the risk for joint stiffening and fusion. Should the hip or knee become fused in a certain position, a surgical release is necessary to allow range of motion to occur. Unfortunately, it takes between 12 and 18 months for heterotopic bone to mature once it has developed. Activities that are used to prevent the development of HO include range of motion programs and other functional activities that move the joints within a functional range.

The GIGER MD® medical device is the best for preventing the heterotopic ossification.

Spasticity: After spinal cord injury the nerve cells below the level of injury become disconnected from the brain. Following the period of spinal shock changes occur in the nerve cells that control muscle activity. Spasticity is an exaggeration of the normal reflexes that occur when the body is stimulated in certain ways. After spinal cord injury, when nerves below the injury become disconnected from those above, these responses become exaggerated.

Muscle spasms, or spasticity, can occur any time the body is stimulated below the injury. This is particularly noticeable when muscles are stretched or when there is something irritating the body below the injury. Pain, stretch, or other sensations from the body are transmitted to the spinal cord. Because of the disconnection, these sensations will cause the muscles to contract or spasm.

Almost anything can trigger spasticity. Some things, however, can make spasticity more of a problem. A bladder infection or kidney infection will often cause spasticity to increase a great deal. A skin breakdown will also increase spasms. In a person who does not perform regular range of motion exercises, muscles and joints become less flexible and almost any minor stimulation can cause severe spasticity.

Some spasticity may always be present. The best way to manage or reduce excessive spasms is to perform a daily range of motion exercise program. The therapy on the GIGER MD® Instruments eliminates spasticity and reduces medication or makes it superfluous.

Autonomic dysreflexia: Autonomic dysreflexia (AD) is a condition that can occur in anyone who has a spinal cord injury at or above the T6 level. It is related to disconnections between the body below the injury and the control mechanisms for blood pressure and heart function. It causes the blood pressure to rise to potentially dangerous levels.

AD can be caused by a number of things. The most common causes are a full bladder, bladder infection, severe constipation, or pressure sores. Anything that would normally cause pain or discomfort below the level of the spinal cord injury can trigger dysreflexia. AD can occur during medical tests or procedures and need to be watched for.

The symptoms that occur with AD are directly related to the types of responses that happen in the sympathetic andparasympathetic nervous systems. Symptoms such as a pounding headache, spots before the eyes, or blurred vision are three direct results of the high blood pressure that occurs when blood vessels below the injury constrict. The body responds by dilating blood vessels above the injury, causing flushing of the skin, sweating, and occasionally goose bumps. Some patients describe nasal stuffiness and will feel very anxious. Uncontrolled AD can cause a stroke if not treated.

The primary risk of AD is stroke. It is a potentially life-threatening condition. If AD is left untreated, the body’s attempt to control blood pressure will severely decrease the heart rate. This, combined with uncontrolled high blood pressure, can be fatal. For this reason, it is very important to treat this condition as soon as possible. The most important thing patients can do to prevent AD from occurring is to take good care of themselves. Patients should monitor bladder output and should maintain a regular bowel program which fully empties the bowels. They should also do regular skin checks to prevent pressure sores from occurring and daily movements of the whole body in the best therapeutic conditions on the GIGER® MD Instruments to decrease blood pressure.

Deep vein thrombosis: (DVT) or pulmonary embolism is a potentially severe complication of spinal cord injury. As mentioned above, there are changes in the normal neurologic control of the blood vessels that can result in stasis or “sludging”. Deep vein thrombosis in the lower leg is almost universal during the early phases of recovery and rehabilitation. Thromboses in the thigh, however, are a great concern, as they are at risk for becoming dislodged and passing through the vascular tree to the lungs. A major obstruction of the arteries leading to the lung can potentially be fatal. Best therapeutic measures to reduce or eliminate completely the risk for deep vein thrombosis are when doing GIGER MD® Therapy because with the GIGER MD® medical device the whole body and all its muscles are in motion and the rate of blood circulation is increased. The pressure in the veins decreases. The blood’s viscosity is also smaller. The blood circulation through the capillarie is also improved. 

Cardiovascular disease: Cardiovascular disease is a major long-term risk of spinal cord injury. Spinal cord injury individuals live in general rather sedentary lives and are at higher risk for cardiovascular disease than the able-bodiedpopulation. Therefore, careful assessment of cardiovascular function and the encouragement of exercise programs are appropriate and necessary long-term aspects of spinal cord injury management and care. With the GIGER MD® Instruments the patient is able to train his body in best conditions.

Syringomyelia: A post-traumatic enlargement of the central canal of the spinal cord is termed syringomyelia. It occurs in approximately 1-3% of all spinal cord-injured individuals. The primary risk of syringomyelia is a loss of function above the level of the original spinal cord injury. For example, in a patient with a thoracic-level spinal cord injury may complain to his or her physician of numbness and weakness involving the extremities. The condition will progress with time and needs to be treated aggressively through surgical drainage. Often patients with early evidence of a syrinx will be followed to evaluate the progression of the condition. Significant syringomyelia is treated with surgical decompression and the placement of a drainage tube into the spinal cord. 

Neuropathic/Spinal Cord Pain: Neuropathic (nerve-generated) pain is a significant problem in some spinal cord-injured patients. Varying types of pain are described in spinal cord injury. Damage to the spine and soft tissues surrounding the spine can cause aching at the left of the injury. Nerve root pain is described as sharp or may be described as having an electric shock-type quality. Occasionally SCI patients will describe phantom limb pain or pain that radiates from the level of the lesion in a specific pattern that is related to injury or dysfunction at the nerve root or spinal cord level. Various medications and nerve block procedures have been described and are of some use in the treatment of neuropathic pain following spinal cord injury but our experience shows and proves every day that therapy on the GIGER MD® Instruments is the best.

Respiratory Dysfunction: Respiratory complications and infection predominate as post-spinal cord injury complications. When the injury involves the upper thorax, the normal breathing pattern is permanently altered. The diaphragm does most of the work in quiet breathing. The chest wall muscles (intercostals) are used primarily for deep breathing or coughing. The abdominal muscles also participate in coughing. When the intercostal and abdominal muscles are paralyzed, the entire load is taken by the diaphragm. This results in poor coughing and a high risk of pneumonia. Pneumonia is one of the most common complications of acute spinal cord injury. Preventive measures are very important to reduce the risk of pneumonia. These include: percussion and drainage using gravity to assist; assisted coughing (also termed “quad” coughing); abdominal binders (to increase the resistance against which the diaphragm works); and early mobilization with the GIGER MD® medical device.

Further complications are:

 – Involuntary control of bladder and bowel

 – Urinary tract infections

 – Kidney and bladder stones

 – Slow healing of any injury to the paralysed limb