Healthcare & Rehabilitation
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Health Care for persons with Mobility Impairments, is the maintenance or improvement of health via the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in those with Mobility Impairments. This Health Care is delivered by a variety of health care professionals, Companies, Organizations, Hospitals and Rehab Units.
Health Care starts with the Diagnosis and Treatment of the Mobility Impairment and most often includes Rehabilitation, which is a culmination of, professional therapies such as Speech Therapy, Hydrotherapy, Occupational Therapy, Physiotherapy and may also include consultations with a Dietitian and Psychologists. Once the Rehabilitation is complete and the patient returns home, they may experience other issues relating to their Mobility Impairment, and so will generally still rely on these and a variety of other Health Care professionals throughout the rest of their lives.
Below is information about some of the complications and issues that can effect persons with Mobility Impairments, as well as the Health Care Professionals, Companies, Organizations, Hospitals and Rehab Units that can assist you with the treatment or prevention of these complications and assist with the maintenance or improvement of the health of persons with Mobility Impairments in South Africa. We have also included the contact details of some these Health Care Professionals.
Surgeons, Hospitals & Rehab Units
Persons who are severely injured or who develop Mobility Impairments through a disease or condition, are most often Hospitalized, so that they may be treated and given time to recover or learn to adapt to their new circumstances. In many cases these patients are sent to Rehabilitation Hospitals or Hospitals that have Rehab Units, that specialize in the rehabilitation and treatment of specific conditions or injuries.
Persons with Mobility Impairments such as Spinal Cord Injuries, will more often than not, have dealings with various types of Surgeons and Physicians. If the person sustained the Mobility Impairment through an injury, the patient will be allocated a surgeon in hospital that specializes in certain types of operations, such as Plastic Surgeons, Neurosurgeons, cardiothoracic surgeons, general surgeons, paediatric surgeons and trauma or orthopaedic surgeons.
After the operation, the patient will generally then be allocated a physician, which will oversee the remainder of their stay at the hospital or Rehabilitation Centre. A Physician or medical doctor is a professional who practices medicine, which is concerned with promoting, maintaining, or restoring human health through the study, diagnosis, and treatment of disease, injury, and other physical and mental impairments.
There are various orthopedic surgeons operating throughout South Africa, visit www.sadoctors.co.za - orthopedic surgeons to find an Orthopedic Surgeon in your area.
Rehabilitation Hospitals are devoted to the rehabilitation of patients after the stabilization of their acute medical issues. The industry is largely made up of independent hospitals that operate these facilities within acute care hospitals. There are also inpatient rehabilitation hospitals that offer this service in a hospital-like setting, but separate from acute care facilities. Most inpatient rehabilitation facilities were created to meet a perceived need for facilities which are less costly than general hospitals but which provide a higher level of professional therapies such as Speech Therapy, Occupational Therapy, and Physical Therapy.
There are various Hospitals or Rehabilitation Centres throughout South Africa, visit our Health Care - Search Facility and search for "Hospitals" or "Rehabilitation Centres" to find one near you, or visit www.sadoctors.co.za - private hospitals to find a Private Hospital or Clinic in your area, or visit www.sadoctors.co.za - state hospital to find a State Hospital or Clinic in your area.
Life & Rehabilitation After Hospital
When someone sustains a spinal cord injury (SCI) for example, they will need anything from three months to a couple of years of rehabilitation in a Rehab Centre before they may be ready to get back into normal life. In many cases, the patient will not recover fully from the Mobility Impairment, as there is currently no cure for a SCI, so this rehabilitation will also teach the patient how to manage the physical aspects of their disability, such as bladder and bowel function, pressure care, use of a wheelchair and other assistive devices, as well as giving them resources to address issues such as independent living, employment and sexual options. Once the patient has completed their stay in the Hospital or Rehabilitation Centre, and it is time for them to return home or to a Self Help Centre, they should have a better idea about what they are up against and the severity of their Mobility Impairment and whether they are likely to recover some movement in the future. There is however still a lot to learn, which can be quite daunting, but there are some companies and organizations that are available that can assist:
After injuries such as SCI's, some persons are not able to return home for a number of reasons, there are however various Self Help Centers, Homes or group homes which provide accommodation for people with chronic disabilities who cannot live with their families due to their disability. These homes cater for young adults, adults and seniors and have trained caregivers available for 24 hours a day, depending on the amount of residence and the care that they need. There are a variety of different types of these centers available throughout South Africa, visit our Self Help Centers Page to find out what is available, or Contact Us for any other assistance.
We at ''Disability info South Africa" supply a “One Stop Free Information Service" for "Persons With Disabilities" in South Africa, who are looking for information that can help them, including information about various types of Assistive Devices or Equipment which is available from various companies throughout South Africa, visit our Assistive Devices Page to find out what equipment is available and which companies provide it, or Contact Us for any other assistance.
Bags of Hope
Other organizations such as the QuadPara Association of South Africa (QASA) provides assistance for people leaving hospital after sustaining spinal cord injuries, by providing them with useful information and products. Once people leave a rehabilitation centre, they often have no further resources to assist them to cope with the changes in their lives. QASA and Coloplast have launched a project called Bags of Hope, which provides a bag full of information to each person being discharged from a Rehabilitation Unit. The bag contains samples of the healthcare products needed to manage quadriplegia or paraplegia, such as catheters. It also contains information on spinal cord injury and its consequences, coping with a Mobility Impairment, sexuality and sexual options after SCI, and the rights of people with disabilities.
When leaving hospital, you will also need to find a General practitioner to assume responsibility for your continuing medical care should any complications arise. When choosing a General practitioner, it is beneficial to choose one that is a specialist in your type of Mobility Impairment, and to try to keep to the same General practitioner over a lengthy period of time, so that you build up a relationship with them and so that they become familiar with your condition.
Complications Related to Mobility Impairments
There are wide variety of complications which can effect persons with Mobility Impairments who are unable to walk. The inability to walk is just the tip of the Iceberg for persons with SCI & other similar conditions or injuries. These "complications" may require specialist treatment and include:
- Loss of Independence
- Development of Pressure Sores
- Loss of Bladder Function
- Loss of Bowel Function
- Loss of Strength & Muscle Tone
- Gaining Weight
Read the article below to find out more information about these "complications" and the Health Care Professionals, Companies, Organizations, Hospitals and Rehab Units that can assist you in South Africa.
Many persons with severe Mobility Impairments may find that their "Loss of Independence" resulting from their disability is one of the most difficult things to get used to. Some persons with Mobility Impairments may need assistance with activities such as Dressing, Transferring Washing, Toiletries, Driving or being Transported, Eating & Drinking, but there are a wide variety of Assistive Devices and techniques that can assist you with this and an Occupational Therapist can advise you on what is available and what would best suite your needs to assist you to become more independent.
Occupational Therapy (OT)
Occupational Therapy (OT) is the assessment and treatment to develop, recover, or maintain the daily living and work skills of persons with a physical, mental, or cognitive disorder. Occupational Therapists also focus much of their work on identifying and eliminating environmental barriers to improve the independence of persons with disabilities, they place emphasis on the progress towards the client's goals and focus on adapting the environment, modifying the tasks, teaching the skills, and educating the client or their family in order to increase participation in and performance of all daily activities including: Self-care, Sports, Hobbies, Home-making, Leisure, Work and Driving.
Driver Training & Assessments
One of the biggest obstacles that many Persons with Mobility Impairments often encounter, is getting their independence back and being able to drive a vehicle or be transported in a vehicle. There are a variety of different types of equipment & adapted vehicles, which are available in South Africa, and some Occupational Therapists and Organizations such as QASA & Rolling Rehab, can help you get back on the road safely, thus giving the independence back to many Persons With Disabilities.
Rolling Rehab: is run by Occupational Therapist Caroline Rule and offers an independent consultancy service where they do a holistic assessment of the individual’s needs and abilities, and advise whether they are safe to start driving or to continue driving after an accident or illness which may have affected their ability to adequately control a vehicle. Each assessment is customized according to the client’s needs and include:
Assistive Devices, Tools & Braces
Another big part of Occupational Therapy is the development of tools or braces and the education of the patient on how to use these Tools and other Assistive Devices, to make daily activities possible or easier to accomplish. These tools include:
- Eating Braces & Adaptive cutlery & utensils - for use at meal times - Visit our Accessories Page - Eating & Drinking Accessories to find out more.
- Writing & Typing Braces & Computer Aids - for an individual that has limited use of the hands or fingers - Visit our Accessories Page or Computer Aids page to find out more.
- Braces/Devices for Hobbies, Sport & Exercise - This enables persons that have limited use of their hands or fingers, to still take part in these activities. Visit our Sports, Exercise & Rehabilitation Equipment to find out more.
- Leg, Arm, Hand & Back Braces that assists you to Stand or to improve posture and prevent injuries. Visit our Seating & Positioning page to find out more about this, as well as the Occupational Therapists and Companies that specialize in Seating & Positioning.
Occupational Therapists often work closely with other Health Care professionals that specialize in Physical Therapy, Speech Therapy, Nursing, Social Workers, and the community. There are various Occupational Therapists throughout South Africa, visit our Health Care - Search Facility and search for an "Occupational Therapist" or visit www.sadoctors.co.za - occupational therapists to find an Occupational Therapist in your area.
Nursing & Private Home Nursing
Depending on the degree of your Mobility Impairment, the Assistive Devices mentioned above may not offer enough assistance to give you your complete independence back, in which case, you may need the assistance of a Nurse or Home Base Caregiver to assist you with your day to day activities, such as Showering, Getting Dressed & Undressed and Transferring from your Bed to Wheelchair and visa versa.
While in hospital, Nurses & Sisters will have assisted you with these activities as well as your recovery from surgery. During your rehabilitation, this care is extremely important for your healing and rehabilitation, as neglect during this time can lead to many other complications, such as pressure soars and bladder infections. When you leave the Hospital or Rehabilitation Centre, you may however still need this type of assistance and care at home and having qualified care is just as important at home.
Private Home Nursing or Home Care is supportive care provided in your home by a Qualified Nurse or Care Giver, this care may be provided on a temporary or permanent basis to ensure that your daily needs are met and includes assistance with bathing or showering, eating, dressing, etc. These services help the patient to stay at home versus living in a facility and are normally paid for by the patient or their family, Home Base Caregivers are therefore often preferred, as they are a cheaper option than a qualified Nurse.
Home Base Caregivers
Home Base Caregivers are generally not as qualified as Nurses, but have completed various home base courses and work for Organizations, Agencies or Companies, who hire them out as the client requires them. One Organization that offers this Service is the PlumRus Community Service Centre:
The PlumRus Community Service Centre: operates from PlumRus which is a home for the elderly that is situated in the beautiful Constantia Valley of Cape Town. The warm ambience and homely feel of PlumRus flows over to the Community Centre where all of our clients are treated in the best possible way and are part of the decision-making process to ensure that everyone plays a part in the success of PlumRus Community Service Centre. The staff members are continually trained to give the best medical, physical and emotional support to the clients.
PlumRus Community Service Centre offers both Home Base Care and Day Care to ensure that their clients are catered for in the best possible way, offering different types of packages to suite the clients needs. They include:
Home Base Care: Plumrus Community Service Centre (CSC) provides basic home base care in the comfort and familiarity of your own home. These services are tailor made to meet the individual clients needs and range from a basic care routine to light housekeeping, engaging activities and companionship. We are able to provide all of this and so much more. You also get to choose when (which days) and for how long (hours of shift) you would like to have us care for you.
Day Care: For up to 12 hours a day you can drop your family member off at our facility and we will take care of all their needs, as if they are a resident of ours. This Day Care includes 3 wholesome meals and activities such as, movies, crochet, bible study, bingo, reading and so much more. We also supply a free clinic service every Monday. All this and more for only R380 per day. Contact Plumrus Community Service Centre (CSC) to find out more.
The Plumrus Community Service Centre (CSC) are also available to assist you if you are traveling to Cape Town and need Home Base Caregivers to assist you. Contact Plumrus Community Service Centre (CSC) on Tel: 021 761 2323, Fax: 021-7613015 or via email: email@example.com to find out more, or visit their website at: www.plumruscsc.co.za.
If you do not live in Cape Town, there are also various Home Base Carers working throughout South Africa, visit our Health Care - Search Facility and search for "Home Base Carers" to find one near you, or Contact Us and we will recommend some in your area.
Care Attendant Training Courses
Due to the high prevalence of pressure sores amongst some persons with Mobility Impairments, some organizations such as the QuadPara Association of South Africa offers Care Attendant Training Courses to it's members who have private carers. Self Help Centre residents has been the cause of much concern over the past few years and in some circumstances, residents have died due the severity of their pressure sores, which is partly due to the fact that very few of the care givers have had formal training about pressure sores and the general care of paraplegics and quadriplegics. Through the QASA and the Momentum National Care Attendant Training Courses, QASA aims to change this, contact them to find out more.
2. Development of Pressure Sores
Pressure Ulcers, also known as Pressure Sores or Pressure Injuries are localized damage to the skin and/or underlying tissue that usually occur over a bony prominence as a result of pressure or pressure in combination with shear and/or friction. These Pressure sores are normally caused from staying in one position for too long and commonly form where your bones are close to your skin, such as your ankles, back, elbows, heels and hips. The Elderly and some persons with Mobility Impairments are at risk if they are bedridden, use a wheelchair, are unable to change position, or have poor circulation and blood flow to the area.
One of the first signs of Pressure Sores is a reddened, discolored or darkened area on the skin, the skin may look purple on persons with darker complexion and may also feel hard and warm to the touch.
Wound healing is an intricate process where the skin or other body tissue repairs itself after injury. In normal skin, the epidermis (surface layer) and dermis (deeper layer) form a protective barrier against the external environment. If the affected skin is broken, you should clean open sores with saltwater (saline) solution each time the dressing is changed. Increasing your protein intake, staying off the affected area and putting on a Dressing speeds up healing. (Pressure sores should be keept moist.)
The wound healing process is not only complex but also fragile, and so is susceptible to interruption or failure, leading to the formation of non-healing chronic wounds. Factors that contribute to non-healing chronic wounds are diabetes, venous or arterial disease, infection, and metabolic deficiencies of old age. If you are affected by any of these or have a wound that is open, you should contact a Wound Sister.
Wound Nursing is provided by Wound Sisters and is the treatment of patients with acute and chronic wounds. These wounds can be caused by medical treatments, diseases, or injuries and these Wound Sisters often work with a healthcare team, assessing patients, managing wounds, and monitoring healing. Wound Sisters provide a modern line of wound care products, for various types of wounds, such as burns, acute and superficial wounds, and diabetic leg syndrome, including surgically complicated wounds. There are various Wound Sisters working in South Africa, visit our Health Care - Search Facility and search for "Wound Sisters" to find one near you, or Contact Us and we will recommend one in your area.
Pressure Sores can be prevented by using various types of Assistive Devices called "Pressure Care Products", or by getting the correct Seating & Positioning in your Wheelchair or bed. Click on the links below to find out more about this, as well as the Occupational Therapists and Companies that specialize in "Seating & Positioning" and sell "Pressure Care Products".
3. Loss of Bladder Function
Many persons with severe Mobility Impairments such as Quadriplegics and Paraplegics have "Loss of Bladder Function", this could lead to problems emptying their Bladder or loss of bladder control. There are various options for people with a neurogenic bladder and they include:
- Medications: Your doctor may prescribe medications to improve bladder function. These medications might help reduce bladder contractions, lower urinary frequency, improve loss of bladder control (incontinence), increase bladder storage or empty the bladder.
- Clean Intermittent Catheterization (CIC): In CIC, you or a health care professional inserts a thin tube (catheter) through the urethra and into your bladder several times during the day to empty your bladder.
- Continuous Catheterization: A health care professional may insert a catheter through your urethra or abdominal wall and into your bladder to continuously empty your bladder.
- Surgical Intervention: Doctors trained in bladder management (urologists) may perform bladder reconstructive surgery that may resolve or improve bladder symptoms and management.
Persons who use CIC or in-dwelling catheters after their injury, can often lead to them experiencing Urinary Tract Infections in hospital or after they return home. UTIs also known Bladder Infections can occur as often as 3 to 4 months apart and occur more frequently for a number of reasons including:
- "Open wounds"
- The cleanliness regime of the carers or persons looking after the person.
- Not drinking enough water.
There are also various products such as Colloidal Silver which can drastically reduce the risk of persons with spinal cord injuries from getting UTI's.
Colloidal Silver is made through a process of electrolysis which creates a solution with a small percentage of silver. Research has shown that organisims like e-coli can survive for hours on stainless steel, whereas if placed on a silver surface, they are killed in less than half-an-hour.
Colloidal Silver is available at many pharmacies in both a liquid and gel and is not very expensive. It is recommended that Colloidal liquid be sprayed around the catheter "wound" two or three times a day.
Using Colloidal Silver Concurrent with a rigorous sterile regime of hand washing and drinking lots of water helps prevent UTI's from developing. Click on the link below to find out more about how Colloidal Silver can help prevent UTI's. (Information supplied by the The National Council of and for Persons with Disabilities -NCPD.)
If this or other treatments don't work, you may want to contact your primary care provider who can often treat simple urological issues, such as urinary tract infections or frequent urges to urinate but if your problems are more complex, or if your primary care provider's treatments have failed, you may need to seek specialized help from a Urologist.
Urology & Urologists
Urology is the branch of medicine that focuses on surgical and medical diseases of the male and female urinary-tract system and the male reproductive organs. Urologists specialize in the health of the urinary system, as well as male reproductive health and deal with Organs which include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs.
Persons with brain and spinal cord injuries may have urological issues, as in many cases the brain and spinal cord signals don't properly travel to the urinary system, resulting in incontinence, erectile dysfunction, loss of sensation, or difficulties with sexual arousal. In other cases, spinal cord or brain injuries give rise to disuse that causes the urological system to deteriorate. Urological infections are also prevalent among spinal cord injury survivors, particularly those who are immobilized in hospital or unable to void without assistance. In cases such as these, the Doctor or Urologist would normally recommend that the patient use a catheter to void their Bladder. (See information above.)
3. Loss of Bowel Function
A Spinal Cord Injury or a nerve disease may also damage the nerves that help control the lower part of your colon, therefor causing "Loss of Bowel Function." The muscles and nerves around your rectum and anus need to work together for your bowels to work properly. Nerves control the muscles of the rectum, and they signal when the rectum is full, damage to these nerves can interfere with bowel control. This damage may reduce the peristalsis in the muscles around the colon and may block signals to or from the rectum and anus. This means you may not feel when you need to have a a bowel movement (BM) or you may not be able to have a BM when you want. This often causes constipation and bowel accidents and gets in the way of your normal ability to store and eliminate waste.
There are various Bowel management options for people with a neurogenic bowel, they include:
- Medications: Your doctor may prescribe medications to manage timing and consistency of bowel movements.
- Anal Irrigation: Anal irrigation is a new conservative bowel management therapy, whereby fluid is inserted through a catheter with an inflatable balloon to reduce constipation and assist in effective bowel movement and management.
- Surgical intervention: Surgeons trained in bowel surgery (colorectal surgeons) may perform reconstructive surgery to resolve difficulties in bowel management. Surgical interventions can also include a stoma operation, so that a colostomy is used.
There are various "Colonic Hydrotherapists" throughout South Africa, visit www.sadoctors.co.za - Colonic Hydrotherapists / Hydrotherapy / to find a "Colonic Hydrotherapists" in your area.
Stomas & Stomal Sisters
Some persons including some Quadriplegics and Paraplegics choose to have their bowel surgically relocated to open onto the abdomen, this opening that is created is called a 'stoma' and it is enclosed in a sealed bag system. Stomal Therapy is the management of stomas and Stomal Sisters or Stomal Therapists are responsible for helping patients adjust to living with either a permanent or temporary colostomy. This role includes pre-operative counselling, immediate post-operative care and education and follow-up assessment and counselling following patient discharge. Some Stomal Therapists also provide the equipment that the patients need on a monthly basis.
4. Loss of Strength & Muscle Tone
Loss of Strength and Muscle Tone, is one of the more noticeable complications or side effects of having a serious Mobility Impairment, whether it be through disease or injury. Persons who are permanently in a wheelchair, or are bedridden and are unable to move their arms or legs may start to experience Muscle atrophy where your muscles start to waste away due to lack of physical activity. This type of atrophy often occurs just after you are injured and are recovering in hospital, but can often be reversed with exercise and improved nutrition. Regaining muscle mass is beneficial for people of all ages and improves appearance, increases strength and lowers blood pressure, it also increases bone density and helps reduce the risk of osteoporosis-related fractures.
You can regain muscle mass quickly by incorporating strength training into your daily routine and making a few minor dietary modifications such as increasing your protein intake. You should eat up to 1 gram of protein per pound of body weight during your rebuilding period and also increase your intake of vegetables, healthy fats, and fruits, and consider supplementing with fish oil. You also need to make sure that you get enough sleep and vitamin D and don't cut carbs but limit your alcohol intake. A Dietitian can also assist you to draw up a diet to assist with this, visit our Dietitian section below to find out more, or visit our Exercise & Rehabilitation section below.
5. Weight Gain
Some persons with Mobility Impairments who use wheelchairs or scooters are also at a high risk of weight gain, after initially losing weight when they are first injured, as mentioned above. After returning home from hospital, they often find it difficult to gauge how many calories they need to eat and so eat more than they need, but use less energy through physical activity, and so begin to put on weight. Some adults who use wheelchairs then find it harder to lose weight, because they tend to use fewer calories through the fact that they are often less active. “Wheelchair users also tend to lose muscle in their legs over time and less muscle requires fewer calories to maintain your bodyweight.”
Persons with Mobility Impairments, especially those who use Wheelchairs can encounter various complications if they are overweight or obese, these complications include:
- Difficulty Transferring or being transferred
- Increased risk of Pressure Sores
- A range of serious health conditions, including type 2 diabetes, heart disease and certain cancers.
There are however still changes you can make to achieve a healthy weight, but you will need to adjust your diet and level of physical activity, to use more energy than you consume through food and drink. You can start by eating fewer calories and being more active. If your ability to move around is severely restricted by your condition, then dieting will be the main way that you can lose weight.
You should aim to lose between 0.5kg and 1kg a week until you reach your target weight, thereafter a healthy, balanced diet and regular physical activity will help you to maintain a healthy weight in the long term. Tips to losing weight include:
- Get into a regular eating pattern
- Achieve a balanced diet
- Become more physically active
- Drink lots of water throughout the day and before meals
- Reduce overeating and portion sizes.
- Avoid alcohol, sugar and to many starches
- Learn new long-term lifestyle skills
The average man needs around 2,500 calories a day to maintain his body weight. The average woman needs around 2,000 calories a day. If you are a wheelchair user, it’s likely you’ll need less calories than these guideline amounts, but becoming more active is important to maintain a healthy weight and this will help you to use more calories regularly than you consume in food and drink, which will lead to better fitness and help weight loss. Contact your Doctor to discuss an exercise plan and a Dietitian to help you to work out your daily calorie needs.
A Dietitian is an expert in human nutrition and the regulation of a diet. A Dietitian alters their patient's nutrition based upon their medical condition and individual needs. Dietitians are the only healthcare professionals licensed to assess, diagnose, and treat nutritional problems.
Regulating the diet of patients with certain conditions or mobility impairments is out of physician's scope of expertise, thus a Dietitian must be called to permit any changes based upon their knowledge of nutritional biochemistry. Dietitians work in a variety of settings including hospitals, health-maintenance organizations, private practices, and other health-care facilities.
After learning about a patient's health history, favorite foods, eating and exercise habits, the dietitian helps the person to set goals and to prioritize. Follow-up visits often focus on maintenance and monitoring progress.
A balanced diet is important to staying healthy, but exercise together with a balanced diet, is even more important to reduce your weight and to stay healthy. You should aim to do regular cardiovascular activity, as well as regular muscle-strengthening exercise. Cardiovascular physical activity is particularly important when it comes to losing weight. This activity raises your heart rate and gets you slightly out of breath and can causes you to break a sweat.
Exercise & Rehabilitation
Rehabilitation is a step-by-step process that helps persons to recover and to function as effectively as possible after a life-changing event. For persons with Mobility Impairments, this may include getting them moving again, helping them regain their strength, relearning old skills, or finding new and different ways of doing things. A team of doctors, nurses, social workers, physiotherapists and occupational therapists will oversee the rehabilitation process. Rehabilitation may be needed for a short period – for example, after an operation – or for a longer time, such as after a stroke. The length of time is decided by the team and can take place:
- in hospital or in an in-patient rehabilitation facility
- on a long-term outpatient or day patient basis at a hospital
- in a community rehabilitation centre or in the person’s own home, depending on where the person lives.
As mentioned above, a balanced diet is important to staying healthy, but exercise together with a balanced diet, is even more important, as this will assist you to reduce your weight quicker and to stay healthy and assists you to keep motivated and to stick to a balanced eating plan.
It is recommended that to improve fitness, adults with SCI should engage in at least 20 minutes of moderate to vigorous intensity aerobic exercise two times a week and three sets of moderate strengthening exercise for each major functional muscle groups two times per week. To improve cardiometabolic health, it is suggested they engage in at least 30 minutes of moderate to vigorous intensity aerobic exercise, three times per week.
There are a variety of different ways that you can exercise, including doing regular:
- Electro Therapy
- Hippo & Horse Riding Therapy
- Exercise at home or in the gym
You should start slowly and build into it, whether you are playing sport, going to therapy, exercising at home or spending time at the gym.
Physical therapy involves the illnesses, or injuries that limit persons abilities to move and perform functional activities in their daily lives. Physical therapists use a persons history and physical examination to arrive at a diagnosis and establish a management plan which commonly includes prescription of or assistance with specific exercises, manual therapy and manipulation, mechanical devices such as traction, education, physical agents which includes heat, cold, electricity, sound waves, radiation, prescription of assistive devices, prostheses, orthoses and other interventions.
Physical therapists also work with individuals to prevent the loss of mobility before it occurs by developing fitness and wellness-oriented programs for healthier and more active lifestyles, providing services to individuals and populations to develop, maintain and restore maximum movement and functional ability throughout their lifespan. This also includes providing therapeutic treatment in circumstances where movement and function are threatened by aging, injury, disease or environmental factors, it is therefore important to continue with physiotherapy throughout your life, even once your rehabilitation period is over.
Physical therapists offer a variety of different types of treatments to assist in rehabilitation and recovery. These include Standing & Walking Rehabilitation; Hydrotherapy; Electrotherapy and even Hippo Therapy.
If you don't already have a Physio Therapist, you can search for a Physio Therapist on our Health Care - Search Facility or visit www.sadoctors.co.za - physio therapists to find a Physio Therapist in your area.
Standing & Walking Rehabilitation
Our bodies were made to be upright and so standing delivers enormous health benefits for all persons, especially those who use wheelchairs. These benefits include:
- Standing strengthens virtually every muscle in the body. The feet, legs and abdomen are used and strengthened every time a person stands
- Bone density is improved by standing, particularly in the feet, legs and spine
- The occurrence of Scoliosis (or curvature of the spine) is reduced by using a standing frame
- Standing has positive impacts on a person's hips and spine
- Standing improves digestion; The urinary tract drains better and bowel function is improved
- The body's respiratory and circulatory systems are also improved when in the standing position.
- It improves your overall posture.
- Standing prevents pressure ulcers caused by prolonged sitting by changing your position and therefore relieving pressure areas.
- Standing increases self-confidence, self-esteem, self-image and overall quality of life.
Standing Frames, Standing Wheelchairs, Parallel Bars and Tilt Tables can all be used to assist persons with Mobility Impairments to be able to stand.
Advances in research also suggest that functional neuro-recovery offers tremendous potential in rehabilitation medicine. The rewiring of neural pathways or the recruitment of new pathways to control movement offer hope for the restoration of function following traumatic injury, as the central nervous system is malleable and can still adjust and relearn post-injury.
Body weight supported gait training is used in various Rehabilitation Units in South Africa and provides the sensory experience of walking, with the goal of re-training neural pathways, ultimately resulting in ambulation. Trained physical therapists provide the necessary manual assistance, facilitating extension of the hip, knee, and ankle. This training helps to improve balance, motor control, weight-bearing ability and the re-creation of a natural gait. It also increases endurance and speed.
This type of Rehabilitation has shown great benefits and is practiced in South Africa at Rehab Units such as The Walking For Brandon Foundation, who uses the Ekso Suit. Parallel Bars
Hydrotherapy, is a form of physiotherapy, that involves the use of water for pain relief and treatment, it encompasses therapeutic methods that take advantage of the physical properties of water, such as temperature and pressure to stimulate blood circulation and treat the symptoms of certain diseases. It is also used in the treatment of a variety of different conditions, including paralysis, arthritis and related rheumatic complaints.
Hydrotherapy differs from swimming because it involves special exercises that you do in a warm-water pool, whereby the temperature is usually 33–36ºC, which is warmer than a typical swimming pool. Hydrotherapy treatment is done with a physiotherapist who will show you how to do the exercises. The focus of the exercises can be adjusted to help your range of movement or strength, depending on your symptoms, it is different to aquarobics, which can be quite strenuous, as Hydrotherapy is generally more focused on slow, controlled movements and relaxation.
If you don't already have a Physio Therapist, that does Hydrotherapy you can search for a Hydro Therapist on our Health Care - Search Facility.
Electrotherapy is the use of electrical energy as a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological disease. Electrotherapy is primarily used in physical therapy and has been researched and accepted in the field of rehabilitation for the following:
1. Pain management - Improves range of joint movement
2. Treatment of neuromuscular dysfunction: Improvement of strength; Improvement of motor control; Retards muscle atrophy; Improvement of local blood flow.
3. Improves range of joint mobility: - Induces repeated stretching of contracted, shortened soft tissues.
4. Tissue repair: Enhances microcirculation and protein synthesis to heal wounds; Increased blood flow to the injured tissues increases macrophages to clean up debri; Restores integrity of connective and dermal tissues.
5. Acute and chronic edema: Accelerates absorption rate; Affects blood vessel permeability; Increases mobility of proteins, blood cells and lymphatic flow.
6. Peripheral blood flow - Induces arterial, venous and lymphatic flow.
8. Urine and fecal incontinence: Affects pelvic floor musculature to reduce pelvic pain and strengthen musculature; Treatment may lead to complete continence.
9. Lymphatic Drainage - Stimulate lymphatic system to reduce edema.
If you don't already have a Physio Therapist, that does Electrotherapy you can search for a Electrotherapist on our Health Care - Search Facility or visit www.sadoctors.co.za - physio therapist to find a Physio Therapist in your area and check with them to see if they offer it.
Hippo & Horse Riding Therapy
Horse riding is available for persons with Mobility Impairments in South Africa, as a sport, hobby and as various forms of therapy, known as Horse Riding Therapy, Hippo Therapy & Equine Therapy. Horse Riding can be enjoyed by children of almost all ages and the Therapy whereby horses are used have a major physical and emotional impact on people with a wide variety of issues and disabilities, including persons with Physical disabilities or Mobility Impairments. These benefits include:
If you don't already have a Hippo Therapist, you can search for a Hippo Therapist on our Health Care - Search Facility.
Exercise At Home Or Gym
Taking part in regular physical activity offers many advantages to people of all ages, and is even more important for persons with disabilities, whether they want to lose weight, reverse muscle atrophy, build strength or improve their mobility. Persons with Mobility Impairments who went through rehab, may have attended Physiotherapy once a day 5 days a week when in rehab, but this is generally not possible when they return home. It is however important to continue with physiotherapy, even if it is once or twice a week and then try to do some other type of physical activity two or three times a week.
It is recommended that to improve fitness, adults with SCI should engage in at least 20 minutes of moderate to vigorous intensity aerobic exercise two times a week and three sets of moderate strengthening exercise for each major functional muscle groups two times per week. To improve cardiometabolic health, it is suggested they engage in at least 30 minutes of moderate to vigorous intensity aerobic exercise, three times per week.
There are various Sports and other activities that can help you to burn fat and build strength, if you push your Wheelchair, you could start by making short journeys by pushing yourself in your wheelchair, or doing various other exercises at home. If the gym does appeal to you, there is a range of good options for wheelchair users, which include rowing machines adapted for wheelchair use, and weight machines for resistance exercises.
Unfortunately not all gyms are wheelchair accessible, so check your local gym to make sure that they are accessible and have equipment that you can use. If you can't find an accessible gym near you or prefer to exercise from home, there is a variety of equipment that you can use which can be adapted for use by persons with limited hand use and you don't need to spend a fortune on expensive weight machines and other equipment.
You can start off with some stretch ropes and dumbbells or wrist or ankle weights and build up from there. There are also a wide variety of You Tube videos available to give you ideas on what exercises are possible for persons in wheelchairs at home or in the Gym: 101 Mobility - Wheelchair Exercise or Seated Exercise videos from YouTube is a link to 101 Mobility, who has compiled information from the Web to show that exercise is possible for people of all abilities, click on the link to find out more.
Some of the equipment that is used in this video, such as the "Active Hands" Gripping Aids is available to purchase from Wantitall.co.za, click on the link to see what equipment they have available, or visit our "Sports, Exercise & Rehabilitation Equipment" page to see what equipment is available to assist you to Stay Active!
Please note that it is advisable to speak to your Doctor before starting to exercise and consulting an expert to find an exercise routine to suite you and your condition. Contact Us to find out more or for any other assistance.
Sports are very important to keep a person healthy and are even more important if that person has had an injury or has a Mobility Impairment and is in a wheelchair. Sports offer many advantages to persons with disabilities and are equally important, not only when you are first injured, to build up your strength, but also in later years, to keep you fit, assist to keep the weight off and to make sure that you don't lose any movement or strength that you have gained since you injury. Persons with Mobility Impairments or Physical Disabilities can take part in a variety of Sports at both club, provincial and international level. Whatever your age, disability, experience level, or gender, there's a place for you in Mobility Impaired sports. Whether you prefer team or individual sports, Winter or Summer sports, high action or something a bit slower, if you've got the enthusiasm & the drive, you can find something in this section that will suit you. Focus on the things that you can do, rather than those you cannot and click on the link below to see what sports are available in South Africa and to find out more about them.
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N.B: This Website is continually changing and being improved some sections may therefor be incomplete or have links and contact details that are outdated. We are making every effort to keep this to a minimum, so we ask for your patients in this regard and to please Contact Us if you notice that your Companies, Clubs, Schools or Organizations details are incorrect or have changed.
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