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Incomplete spinal cord damage: Spastic paretic paralysis In spastic paretic patients the "rules of
spinal locomotion", derived from animal experiments and
found useful in human (Wernig & Müller, 1992; Wernig et
al., 1995) need to be applied. These include: Full extension of
knee and hip joint with full loading of this limb during stance
phase, physiological hyperextension of the hip joint at the end
of stance phase, deloading of this limb and shifting of body weight
onto the contralateral limb. Additional afferent stimulation, like
skin irritation by pinching or pressing or electrical stimulation
may be effective in inducing or facilitating flexion and extension
movements. The optimal positions need to be found by trying; often
for pinching/pressing the foot or digit I, the lower thigh or the
back of the knee joint, for the stimulating electrode a site above
the knee is effective. At this stage special shoes with thin leather
soles are used for the same purpose often with considerable success. |
HANDLING
OF THE PATIENTS. SPECIFIC DISEASES