6 replies to this topic

[Newsjunkie]

Hi all
My brother in law has a complete c4-c5 injury and is currently in a spinal injury rehabilitation unit. We will be visiting him this weekend but we have been told that while he has some movement in his left arm, he doesn't have control over what it does yet, for example, if he tries to lift it might raise up but not exactly when and how he intended it. Is this typical? Will his rehab physio help to give him more control over the muscles that are functioning?
We want to give him hope that he will regain some function.
I have found this forum very helpful and encouraging, you're an amazing group of people!
Thanks for any guidance on this.

[kewlcatkez]

Newsjunkie, on Mar 17 2008, 11:53 PM, said:

Hi all
My brother in law has a complete c4-c5 injury and is currently in a spinal injury rehabilitation unit. We will be visiting him this weekend but we have been told that while he has some movement in his left arm, he doesn't have control over what it does yet, for example, if he tries to lift it might raise up but not exactly when and how he intended it. Is this typical? Will his rehab physio help to give him more control over the muscles that are functioning?
We want to give him hope that he will regain some function.
I have found this forum very helpful and encouraging, you're an amazing group of people!
Thanks for any guidance on this.

Hello Newsjunkie,

I just replied to Nuna's post which is I feel very similar... I will share some of what I said there, but this is just my opinion and perspective based on my RN background and experiences...

It is important to note that if your brother is unable to feel his arm, or has altered sensation at least, it is going to be very difficult for him to control the movement (no or altered feedback). Also it is very likely at his level of injury that he only as some of the muscles working in his arms. For eg at C5 he will probably have voluntary shoulder abduction & elbow flexion, but only have the Brachioradialis muscle working/functioning in the forearm... Due to this mismatch of function in his arm, it means that the movement right now is jerky. Therefore it is difficult to say how much control he will regain over his arms and hands. If he is demonstrating movement of his arms now though, it is likely that his PT will be able to teach him to use the movement in his arm that he does have.

Also, as I said to Nuna, in the weeks and months following a SCI, spasms, jerking movements and perhaps some deliberate movement often begins to appear where there was once nonne/reduced. This is due to the fact that initially there is no reflex action, and so no 'activity' neurologically below the level of lesion. This is during 'spinal shock' -where the impulses are flooded.

As the spinal shock lessens, the reflexes return in a very jerky and twitching fashion - leading to spontaenous contractions of the muscles below lesion. Sometimes, these are mistaken for purposeful movement. Due to the misconnection between the Brain and spinal cord, these spasms, tightenings, pains, cramps and 'electricity' are of course involuntary/unintentional, and as such are as you know, unpredictable.

I hope that this helps, and that your brother continues to gain strength and function,

I hope this helps,

Take care,

K

Edited by kewlcatkez, 18 March 2008 - 01:03 AM.

[Newsjunkie]

Thanks for this, your explanation is very helpful. I'll be travelling to Germany (from Ireland) this weekend to see him so we'll have a clearer understanding. I will encourage him to come to this forum when he can. Do most people with limited/no use of their arms use computers using voice activated software or other means?
Thanks again.
P

[duff]

Hi

I myself am a C4-C5 incomplete...i think incomplete. Anyways, i can say from experience that some control will come back to his arm.

As well with the technology- i use a headmouse extreme, which requires neck/head, and 2 jelybean buttons(big buttons) as my clicks and an on-screen-keyboard called click n type. Dragon is a voice recognition software, but i personally do not lke it, bu it does take alot of training.

PM me with any questions regarding the above or anything else

[topperf]

Hi.

my accident was 9 months ago, I'm still in rehab and they tell me I'm complete.
at first I was only able to lift my arms about 10 cm, now im typing this message. (no hand function, but the index finger is a bit stiff, so)
encourage him to move as much as he can, that is my personal opinion, I can't see how it could hurt.
last, if you can visit him more than in the weekends, he will improve faster from the shoulders and up... (i'm shure you're doing everything human possible, but think about "working in shifts" so to speak)

All the best to the both of you.

Thomas.

Edited by topperf, 24 May 2008 - 08:49 PM.

[ParaforGod]

Hi and welcome to the forum. When I was in rehab I was told although Im a complete T4 Never say Never.
When I first went to rehab I couldn't lift or hold my head up. I though I would never be able to lift it again. It took about a month and my Mom walked one day while I was in rehab and up popped my head. So never say never.

[Newsjunkie]

Thanks so much for the responses. I would like to PM you Duff regarding PC use - I think my BIL would get huge benefit from being able to work a computer and come online to forums such as this one. I am based in Dublin but mu sister and BIL are in Germany so I haven't seen him in a few months now but my sister is in with on a daily basis.

Unfortunately, while he made great progress in terms of coming off the ventilator and recovering some movement in his arm in his first months, he has now been discharged from the Tuebingen Spinal Rehap unit after six months - they said they could do nothing more for him there. He is in a general hospital in Stuttgart while a nursing home bed is being sought for him. My sister is naturally very unhappy as she hoped that he would eventually be able to go home and would be able to do some things for himself, particularly feeding. While they currently live in a first floor apartment with no lift, they were talking about finding a new home. He has some movement in his left arm but cannot use his hand. I am concerned that his specialist physio and OT has now come to an end and I am encouraging my sister to check out exactly what therapy he will now be able to access.
I hope some of you might be able to help me with a couple of questions so that we know what to look for.

1. The first is, what therapies would be worth trying to get for him to maximise his independence?
2. The second is what technologies should we be organising for him now to start giving him some independence, even without the use of his hands? For example aids or software for his laptop, mobile phones or stereos? What started making life bearable again for you or your family member?

Your guidance would be extremely valuable to Werner, my sister and our entire family as we don't know what we should be doing to lift his spirits and maximise his independence.
Thanks so much,
Pauline