How is Paraplegia Treated?

There is no single method for paraplegia treatment; a personalized, multidisciplinary approach is required for every patient. The treatment process is planned according to the type and level of the spinal cord injury and the patient’s overall health condition.

1- Acute Phase Treatment

The primary goal after the trauma or disease that caused paraplegia is to prevent further damage to the spinal cord. In this period, surgical interventions may be applied to relieve pressure or stabilize the spinal cord. Medications are used to reduce swelling and control infections or circulatory problems.

2- Physical Therapy and Rehabilitation

The longest and most critical stage of paraplegia treatment is physical therapy and rehabilitation. The goal is to maximize the patient’s existing functions, prevent muscle wasting, and teach independent living skills.

3- Orthoses and Assistive Devices

Orthoses, canes, walkers, wheelchairs, or special bed systems can be used for paraplegia patients. These devices increase independence and ease daily life.

4- Psychological and Social Support

Paraplegia is challenging not only physically but also psychologically and socially. Psychotherapy is very important for the patient and their family. Vocational rehabilitation and social adaptation programs enable patients to participate actively in community life.

5- Experimental Treatments

In recent years, studies have been conducted on innovative methods such as stem cell therapies, spinal cord implants, and brain-computer interfaces. Although they are not yet standard treatment, these approaches are promising for the future.

What is the Role of Physical Therapy in Paraplegia Treatment?

Physical therapy is the most fundamental and long-term step in paraplegia treatment. The goal is to maximize existing functions, prevent complications, and increase independence. The physical therapy process is personalized according to the patient’s condition and consists of many different methods.

1- Gait Robots and Suspension Gait Systems

Gait robots are computer-assisted devices that exercise the leg muscles of paraplegia patients in a controlled manner. These devices allow the patient to take steps closely resembling a normal walking pattern. These repetitive movements help re-establish communication between the brain and the muscles.

In suspension gait systems, a portion of the patient’s body weight is supported by a special mechanism. This reduces the load on the joints and muscles, allowing the person to practice stepping in a safe environment. In the long term, these applications increase muscle strength, support circulation, and provide psychological motivation.

2- Hydrotherapy

Hydrotherapy involves exercises performed by utilizing the buoyancy of water. Movements performed in water reduce the pressure of gravity, enabling patients to exercise more comfortably and safely. At the same time, the water’s pressure supports circulation, reduces swelling, and helps muscles relax.

For paraplegia patients, hydrotherapy contributes to both muscle strengthening and increasing joint range of motion. It also provides a psychologically relaxing effect. Regular applications can lead to a more independent level in daily living activities.

3- Electrotherapy

Electrotherapy aims to reactivate muscles by applying low-level electrical currents to them. This method can reduce muscle spasms, increase blood circulation, and prevent muscle wasting (atrophy) caused by prolonged immobility. Specifically, functional electrical stimulation (FES) yields positive results when used in combination with walking exercises in paraplegia patients.

Additionally, pain control is provided through methods like TENS (Transcutaneous Electrical Nerve Stimulation). This makes the patient more comfortable and facilitates adherence to exercise programs. Regular electrotherapy applications are a critical support for long-term muscle health.

4- CPM Devices

CPM (Continuous Passive Motion) devices ensure the continuous, passive movement of joints. These devices, particularly used for the knee and hip joints, prevent joint stiffness and maintain range of motion. Since joint limitations can develop in paraplegia patients due to prolonged immobility, CPM is an important supportive method.

These devices also increase blood circulation and help prevent complications such as clot formation. Regular use preserves joint function, facilitating progress during the rehabilitation process.

5- Trunk Balance and Sitting Exercises

Developing trunk balance is crucial for paraplegia patients to be independent in daily life. Exercises aimed at increasing sitting balance enable patients to sit more securely in a wheelchair and perform daily tasks without assistance.

The patient strengthens their core muscles through exercises performed on balance platforms, trunk work with a therapist, and special equipment. This reduces the risk of falling and increases safe mobility.

6- Virtual Reality Applications

Virtual Reality (VR)-based applications have become widespread in paraplegia rehabilitation in recent years. Exercises performed with special goggles and motion sensors strengthen the communication between the brain and the muscles. Patients are more motivated when they exercise in a gamified environment.

This method increases adherence to treatment, especially in younger patients. Furthermore, VR exercises support neuroplasticity—the brain’s capacity to form new neural connections—contributing to functional development.

7- Respiratory and Circulatory Exercises

Respiratory functions can be negatively affected in paraplegia patients due to the weakening of chest and abdominal muscles. Therefore, special breathing exercises prescribed by physiotherapists help increase lung capacity and reduce the risk of infection.

Furthermore, circulatory problems can occur in patients who remain immobile for long periods. Circulation is supported with leg pumping exercises, massage, and positioning techniques. This prevents complications like clot formation and pressure sores.

8- Other Supports in Paraplegia Rehabilitation

In addition to physical therapy, psychological support, vocational rehabilitation, and social adaptation programs are important in paraplegia treatment. This enables the patient to become stronger not only physically but also emotionally and socially. Furthermore, the use of orthoses and assistive devices are crucial tools that enhance independence in daily life.