Paraplegia | Top 15 Mobility And Balance Exercises To Regain Strength And Function

Movement is the major requirement of the human body, but conditions like paraplegia, hemiplegia, tetraplegia, quadriplegia, etc. don't allow an individual to perform certain movements. Individuals suffering from such conditions should involve themselves in regular exercises and activities, to maintain cardiovascular and metabolic health. Individuals suffering from such conditions are more susceptible to high cholesterol, weight gain, and elevated blood sugar.  In today's blog, we will figure out the various exercises that can be done by paraplegic patients regardless of their condition. 

What is Paraplegia?

Paraplegia or Partial paralysis is a form of paralysis in which function is impeded from below the level of injury. Paraplegic patients have perfectly healthy legs but the problem resides in either their spinal cord or brain, which cannot send or receive signals from or to the lower body due to a disease or an injury.

Paraplegia symptoms can vary significantly from one person to person. A paraplegic is someone who is usually in a wheelchair as he cannot move his legs, and cannot feel anything below the level of injury. The patients cannot walk and can have a range of capabilities that may change over time, as their health evolves, physiotherapy helps them learn to work around their injuries.

An exercise routine can help protect an individual against various health issues and also improve overall health. Exercises lead to greater flexibility and increased energy levels and also helps strengthen the muscles and maximize function. Wheelchair exercises make the patient more flexible and also decrease pain.

Discussed below are a few exercises that can help the patient to develop mobility and balance:

Side Leg Lifts

• Slip the front half of the foot into the loop of the leg lifter. Then, lie on the side so that the foot with the leg lifter is on top of the other leg.
• Pull the strap of the leg lifter gently so that the leg raises to the side. The patient should stop pulling when he starts feeling the body's natural resistance and then hold the position to stretch the inner thigh.
• Continue to lift and drop the leg 15 times, then turn to the other side and repeat with the other leg.

Knees to Chest

• Place the leg lifter on one foot and lie flat on the back. Use one hand to slowly pull the strap towards the upper body and the other hand to bend the knee as it moves up.
• When the knee reaches the torso, use the arms to hold it in place.
• Hold the position for several seconds and then slowly straighten the knee and bring the leg back down. 

Knee Extensions

• The patient places the foot into the leg lifter and then gently pulls so that the knee straightens out.
• Then, bring it back down.
• Do this exercise 15 times.
• Repeat the same exercise with the other leg.

Hamstring Stretch

• The patient sits on the floor with the front half of the foot inside the leg lifter.
• Pull the strap up the body so that the entire leg lifts off the ground. Pull until the patient reaches mild resistance, then hold for 10-15 seconds.

Ankle Rotations

• The patient sits with one leg bent to the side so that he can easily reach the foot. Use one hand to stabilize the ankle while the patient uses the other to move the foot in circles.
• Rotate clockwise direction and counterclockwise direction.

Ankle Pulls

• The patient sits on the floor and places the leg lifter on one foot.
• The legs should be straight and then slowly pull the strap towards the body so that the toes point towards the ceiling.
• Hold for 10-15 seconds and then repeat.

Seated Elliptical

• The patient uses a seated elliptical to help passively exercise the legs.
• The machine connects the arm and leg movements, so by swinging the arms back and forth, the patient promotes cycling motions in the legs.
• As the patient is seated, the legs will not be bearing any weight.

Seated Marches

• The patient is in a seated position, alternate lifting the knees as if the patient is marching. Bring the knees up as high as he can.
• This exercise develops the leg lifting motions necessary to walk again without bearing additional weight on the joints.

Hydrotherapy

• Hydrotherapy helps individuals with paraplegia relieve pressure from the legs by exercising in a pool. Buoyancy is the property of water that helps keep the body afloat and the patient feels light. Walking in a pool removes pressure from the joints and allows the patient to practice standing without bearing much body weight.

Heel Taps

• The patient lies down with his knees bent and feet flat on the ground.
• Gently tilt the torso to the side and tap the heel with the fingertips. Only the upper half of the body should be moving. Then, simultaneously tilt to the other side and repeat.

Sitting on a Stability Ball

• Sitting on a stability ball requires constant adjustment of the center of gravity (COG), which continuously engages the core muscles. With the help of a physiotherapist, sit on a stability ball, and substitute a stability ball for a chair a few times a day to improve balance. To avoid falling, lean the stability ball against a stable surface like the corner of 2 walls before getting on and off.

Stability Ball Crunches

• Once the patient can sit on a stability ball, make the patient lean back and perform crunches. Crunches on a stability ball help to reduce strain on the tailbone.

Knee Planks

• The patient lies on the stomach and gently gets on the knees and forearms, often called a quadruped position.
• The back should create a straight, downwards-sloping line from the shoulders to the knees.
• Hold for 20-30 seconds and repeat.

Gait training exercises: Weight-Bearing Treadmill Training

• Once the patient develops enough control and strength in their legs to bear weight, then exercises that help to develop their gait are recommended. Gait training is a type of exercise training that focuses on developing the ability to walk. These exercises for paraplegia include weight-bearing treadmill training and overground training.
• The patient is made to wear a harness for weight-bearing treadmill training, the harness controls the amount of weight that is placed on the legs, thus reducing the pressure on the joints. Paraplegic patients can focus on improving their walking form by gradually accustoming the legs to add weight until the patient can support the full body weight.

Gait training exercises: Overground Gait Training

• Paraplegic patients can improve their gait by gait training exercise that involves using equipment like parallel bars, walkers, and canes, to maintain balance. These assistive devices teach the patient, how to shift weight and maintain balance.

Muscle mass decreases due to paraplegia, causing muscle atrophy. To prevent or reduce muscle atrophy regular exercise is the most effective way to slow down muscle atrophy and improve blood circulation and metabolism.