Paralysis and Physiotherapy: How do they connect?

Paralysis is the result of the loss of muscle use in a particular part of the body because the signals passed between the brain and the muscles are tampered. Major causes for paralysis are stroke and trauma with nerve injury. Blocked blood vessels or injury to the brain can cause a stroke resulting in issues like difficulty with speech and understanding, swallowing, sensation and mobility in the muscles etc.

Types of Paralysis

There are different types of paralysis based on the parts or the area of the body that is affected in the patient:

• Monoplegia, when only one limb gets paralyzed.
• Hemiplegia, in which the arm and leg on one side of the body is paralyzed.
• Paraplegia, that affects the lower half of the body, including both the legs, gets paralyzed. Paraplegic patients are able to lead a fairly independent life, by using a wheelchair for their daily activities.
• Quadriplegia, when both the arms as well as both the legs are paralysed. Patients suffering from this form of paralysis require a dedicated caregiver to look after their basic day to day needs.

Effects of Paralysis

The effects of paralysis vary as per the mechanism of injury or disease that has caused it. If it is caused by a progressive condition such as Multiple sclerosis or Parkinson’s, it is less likely that the patient would recover from the condition. In case of a non-progressive disorder such as stroke or spinal cord injury, patient’s condition will not worsen any further and can also be recovered with the help of physiotherapy. The commonly observed effects of paralysis are:

• Weakness or complete loss of muscle strength
• Floppy or tight muscles
• Muscle spasm
• Reduced muscle bulk
• Reduced or complete loss of sensation
• Reduced range of movement at joints
• Reduced mobility
• Reduced ability to carry out daily activities
• Co-ordination and balance problems
• Speech and swallowing problems
• Pain
• Visual disturbance
• Changes to personality/behavior/memory/cognition
• Anxiety/depression
• Bladder and bowel dysfunction
• Sexual dysfunction
• Treating paralysis with Physiotherapy

There is no cure for paralysis at the moment. However, its treatment harnesses physiotherapy to make patients as independent and mobile as possible. Medication and surgery are all also the means of treating paralysis. Very often, treating underlying causes of paralysis using physiotherapy restores mobility in the affected body part.

But it is necessary that physiotherapy should be started at the earliest possible time. It will help in improving blood circulation and relaxing the muscles in the paralytic patient. Physiotherapy also hampers the progress of paralysis. It works best when the condition has occurred due to factors like stroke or a transient ischemic attack. Treatment using physiotherapy can improve muscle tone and the general well-being of the patient. Although, physiotherapy treatment for paralysis is slow and laborious, daily physiotherapy can help restore movement and sensation in the affected limbs to a great extent. Physiotherapy also helps maintain and build strength in the affected muscles. This will help prevent the limbs from suffering deformity and becoming defunct at all. While the limbs are recovering, physiotherapy helps in retraining the nerves and muscles.

When a brain has suffered an external injury, physiotherapy may reduce swelling and hasten recovery. This may involve working on unaffected muscles, so they can compensate for the muscles rendered immobile by the condition. A physiotherapy regimen may include the use of adaptive equipment such as braces, canes, or wheelchairs to foster better mobility and support to the patient.

Physiotherapy often liaised with expertise from other health professionals like orthoptist, psychologist, speech and language therapist, helps in ensuring holistic management and optimum improvement in overall quality of life. This benefits the patient in safer and quicker recovery from paralysis.

Source: HCAH