Paralysis is a medical condition where a person experiences loss of muscle function in the body and suffers from loss of any feeling in the affected part. It can either affect one side of the body, known as hemiplegia, or both sides of the body, known as diplegia.
Paralysis can be caused due to various reasons, and the most common reasons are any form of injury to the spinal cord or head, stroke and multiple sclerosis. At the moment, there is no cure available for paralysis yet. While this can be a difficult thing to live with, especially if you or your loved one has suffered a paralytic attack, there are various aids and methods that can bring some improvement in the condition.
The time taken to recover from a paralysis attack can differ from patient to patient. Also, the amount of recovery that the patient will experience can differ from person to person, wherein some patients may achieve more positive results as compared to others. Your doctor, as well as your physiotherapist, will be able to let you know about your overall condition and recovery chances based on the severity of your condition, and also based on how well you follow the rehabilitation process.
Types Of Paralysis
The type of paralysis that a patient suffers from will depend on the type of injury or cause that led to the paralytic attack. As a result, the doctor will analyse the patient’s overall condition and then suggest the right type of treatment approach.
Here are the different types of paralysis that affect most people:
Quadriplegia
It is the type of paralysis in which all four limbs of the patient, as well as the main body, is affected with paralysis. This type of paralysis occurs when a person suffers an injury to the spinal cord above the thoracic vertebra (the segments in the upper area of the spine). In some patients, quadriplegia can also take the form of tetraplegia, which is a type of paralytic condition in which the patient loses any sort of sensation and movement in three limbs.
Paraplegia
It is the type of paralysis in which the patient loses the ability of movement in both the legs. This type of paralysis occurs when a person suffers from an injury below the thoracic vertebra. Most people who are confined to a wheelchair after suffering from a paralytic attack have paraplegia.
Monoplegia
It is the type of paralysis in which the patient loses the ability of movement in any one limb. This type of paralysis takes place when the person suffers from a spinal injury in which there is some damage to some of the localized areas in the peripheral nervous system (the part of the nervous system which contains the nerves that are outside the brain and spinal cord). It could also happen from damage to related parts in the motor cortex (the part of the brain that is involved in the process of helping you plan, control and execute various voluntary movements).
Diplegia
It is the type of paralysis in which the person will lose any form of sensation and the ability for movement in symmetrical parts of their body, such as on both sides of the face or both the arms and so on. These are the two most common parts of the body that are affected in case of diplegia. This type of paralysis also happens when the person suffers from any type of injury to the spinal cord.
Hemiplegia
It is the type of paralysis in which the person loses any form of sensation and the ability for movement in only one side of the body. As a result, there will be no sensation or ability of movement in that entire area from the affected part down one entire side. This type of paralysis often happens when the person suffers from stroke that affects one hemisphere in the brain.
The Brunnstrom Approach Towards Stages Of Recovery After An Attack
The Brunnstrom approach was first developed by an occupation and physical therapist named Signe Brunnstrom from Sweden, in the 1960s. It has 7 stages, where each stage explains the way a patient can regain motor control after suffering an attack.
Stage 1
- The first stage is more of shock, where the patient tries to recover from the initial reaction of what has happened. This is also the time when the patient will experience flaccidity, a type of flaccid paralysis where the patient will not be able to perform any voluntary movements at all in the affected areas. This is the type of paralysis that is caused as a result of damage to nerves, because of which the muscles do not receive the right signals from the brain.
- As a result, the patient is not able to make the required movements. During the early part of flaccid paralysis, the patient will not be able to initiate any type of movement in the muscles in the areas that are affected, and in some cases in the entire side of the body that is affected.
- It is important to start physiotherapy or occupational therapy at this stage, because if the affected muscles are not put into use, they have the risk of becoming weak and losing their functionality completely. It will also help the muscles to be able to get back to their proper function once rehabilitation is complete.
Stage 2
- During the second stage, the rehabilitation program will look at redeveloping some of the basic synergies of the limbs, such as stimulating and activating some of the muscles in the affected area. It will help the muscles to start responding to initial treatment. The muscles at this stage will start showing some abnormal activity, such as making abnormal involuntary movements.
- Even if these movements are involuntary, the fact that there is some movement can always be a good sign that there is some potential in the rehabilitation. Some patients may also show a minimal amount of voluntary movements in the affected areas, but this is not very common.
- Muscles are linked to each other, so once the therapy begins in the affected area, your therapist will also start working on the muscles of the nearby areas. As there is movement in the muscles present around the area that is affected, it will also start to create a positive movement in the exact muscles that are affected, with partial movement at the start, and more with continued rehabilitation.
Stage 3
- During the third stage, the patient will experience more spasticity in which the muscles will have a feeling of stiffness and tightness. This happens because of the damage that is caused to the nerve pathways in the brain or in the spinal cord, the ones that help to control movement. As the motor neurons in the brain are not controlled fully during this stage, the muscles experience more contraction, which hampers movement.
- As a result of this type of spasticity, the patient can experience a sudden and severe increase in muscle stiffness that can cause a lot of pain and discomfort, and also make it difficult for the patient to make any movement. Some patients may be able to experience some small amount of movement in their muscles, but will not be able to control it yet.
- During this stage, the patient will not be able to carry out the exercises independently. It is important to do the same with the help of a therapist who can support and help the patient perform the exercises properly. The therapist will also guide the caregiver and the family members about ways in which they can assist the patient on a daily basis. The therapist will perform a series of passive exercises, or passive range of motion (PROM) exercises during this stage, to improve chances of random motion.
Stage 4
- By the fourth stage, the spasticity in the muscles will start to reduce and get better. At this stage, the patient will be able to get some control over their muscle movements and may be able to move them voluntarily, at least a little. Initially, the movements may not be fully controlled and be out of sync, but this will improve with regular exercise and practice.
- Around this time, the therapist will mostly focus on strengthening the muscles and improving the patient’s control over controlling the muscle movement. As a result, it will help the patient build strength in the affected limbs and stretch the muscles more.
- The therapist will use a series of active assisted range of motion (AAROM) exercises during this stage that will help the patient with movement. In some cases, the therapist may assist the patient try out certain exercises by using their own body for support, such as holding the patient’s arm or elbow, leg and so on. In other instances, the therapist may use a range of exercise equipment such as strengthening bands, dumb bells and others, to help the patient carry out certain exercises.
- Some patients will also be able to try out exercises independently around this stage, known as active range of motion (AROM) exercises. Some such simple exercises that require voluntary movement are rotating the wrist, bending the elbow and so on. These types of exercises will help to improve the flexibility and endurance in your muscles, as well as overall muscle strength. It is important to perform these types of exercises on both sides of the body, irrespective of which side is affected by the paralytic attack. Your therapist will be able to guide you about the right type of exercises, as well as any additional tools and support aids that you may require at this stage.
Stage 5
- During the fifth stage, the spasticity in the muscles will keep reducing, as in the previous stage. Also, there will be an improvement in coordination between the muscles that will help the patient to make more voluntary movements as compared to earlier rehabilitation stages. The patient will also have less of abnormal movements, even though there may be a little residue left from the earlier stages.
- By this stage, the patient will be able to have more focused and controlled movements in the affected limbs, as well as movement in some of the affected joint areas.
- Your therapist will assist you in carrying out voluntary movements that are more goal oriented. Such movements involve using the brain to send out motor impulse that can help take control of movement. Thinking about doing a particular activity also helps to activate the sensory stimuli that help to trigger impulses from the brain.
- To perform the voluntary movements properly, the patient will have to repeat the same action over and over again. Over a period of time, it will require less time and attention to be able to carry out these movements. Some examples of voluntary movement exercises include regular everyday acts such as eating with proper cutlery, combing hair, brushing teeth and so on.
Stage 6
- By the sixth stage, the spasticity in the muscles will almost be gone. The patient will be able to make more voluntary movements in individual joints and the synergy and motions will be more coordinated.
- The patient will also regain almost full control over motor control and may be able to perform more complex actions.
- By this stage, the therapist and doctor will be able to assess how much more time it will take for the patient to reach full recovery, and whether or not it seems likely.
Stage 7
- The seventh or the last stage is the one by which time the patient will be able to regain almost full control over movement in the areas that have been affected by the paralytic attack. The patient will now be able to move the arms, legs and feet and be more independent.
- This is the most sought after stage that the therapist and doctor will try to reach with the patient.
Benefits Of Physiotherapy For Paralysis Recovery
In addition to helping you customize an exercise plan that will help you bring back some movement in your limbs, a physiotherapist can also help you in the following ways:
- Help the patient take a bath, use the washroom, dress and eat
- Assist the patient use various mobility aids such as the wheelchair, a cane, a walker or any other devices that can help the patient to move from one spot to the other
- With persistent physiotherapy and occupational therapy, the patient can get back enough movement that will enable them to return to work if required
- Physiotherapy and occupational therapy can also help the patient to strengthen the muscles and also stay more and more active. Even if the patient cannot walk yet, regular movement of the limbs will help the patient to regain at least some movement.
Benefits Of Using A Customized Physiotherapy Rehabilitation Plan
At Care24, our team of experienced and trained physiotherapists will assist you in carrying out all the required types of exercises right in the comfort of your home. As a result, you will not be required to make any additional trips and will be in the company of your family members.
The therapist will offer you complete personal attention, which is always helpful in speeding up the recovery process. The therapist will also be able to assess your condition on a daily basis, as well as keep a track of your overall progress, based on which they can modify the exercise plan.
Each session with our Care24 physiotherapist lasts for at least 30 minutes, and can be extended if the therapist feels it is required. During the session, the therapist will help the patient carry out various exercises that will improve mobility. These exercises can be simple ones, or the therapist will use additional support tools.
Does Age Affect The Time Taken To Recover From Paralysis?
Age may have a bearing on how long you take to recover from paralysis, as your body will take longer to heal. Also, if you are suffering from any other type of health condition, it will have a direct impact on the overall time it takes for you to recover from paralysis.
Real Survivor Story
22 year old Simarpreet Singh suffered a paralytic attack in the year 2005, after being in an accident. However, this young man who was paralyzed from the waist down, went on to top the CAT with a score of 99.97 percentile. The young man, who now works in a private firm, has been in a wheelchair ever since the accident. You can read his full story. Read more…
A professional caregiver can help take care of most of the caring needs for a paralysis patient at home. You can book an appointment today on our website, and also speak to the doctor for various treatment options.