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IN SPIRIT Health Information and Resources

News Story

A recently developed surgery involving tendon transfer may help restore arm and hand function in some persons with spinal cord injury.  We have no direct experience with anyone who has had the procedure, but it does sound worth checking out. 
Restoring Hand Function after Spinal Cord Injury
Tendon Transfers

You can also contact Dr. Rick Lieber at the University of California San Diego (rlieber@ucsd.edu) who recently participated in a Hand and Arm Function Research Survey.

Pneumonia Preventative Steps
Persons with high level quadriplegia are about 150 times more likely to die from pneumonia than the general population. In addition to seeing a doctor and getting appropriate vaccinations and treatments, the following simple steps can help prevent pneumonia.

• Drink plenty of liquids
• Do breathing exercises, with assistance if needed
• Breathe through your nose, not your mouth
• Sit right if possible
• Lose weight, eat healthy foods
• Sleep on your side, not on your back
• Limit time in a supine position
• Wear abdominal binder if diaphragm muscles are weak

Assisted Cough (Quad Cough)
By having someone assist you in coughing, your cough will be more forceful and productive and you will be able to both prevent and treat some respiratory complications by bringing up secretions normally present in the lung. Indications for an assisted cough are:

• Weak or ineffective cough, and/or
• Excessive secretions

Reasons to avoid an assisted cough are:

• Pain
• Internal problems, such as abdominal complications, where pushing on the abdomen could cause more complications
• Chest injury ( broken ribs)
• Flail chest, where the chest has excessive mobility, usually due to paralysis of the muscles which control it.

Following is the procedure for an assisted cough:

• Place the fist of one hand, immediately below the breastbone, and the heel of the other hand on top of the breastbone. The hands need to be over the diaphragm area.
• The hand position may vary from the illustration, but the hands must be below the ribs.
• Take a breath and cough as you exhale the air. Your assistant should push inward and upwards as you cough. NOTE: If you are on a ventilator, your assistant should push during inhalation. An ambu-bag may be substituted for the ventilator for a stronger cough.
• Repeat, as necessary, with rest periods, as needed, between efforts

Assisted coughing can be used while in bed or sitting up. Be sure the brakes of your wheelchair are locked before assisting cough. If lung congestion is present, assisted coughing is more effective when combined with postural drainage.