Q & A #2

Are any of the PTs that you know doing this on patients? I was put on a tilt table 3 days out of ICU, and I was on a vent. This was in Germany decades ago. Why are we playing around with rats when this should be happening to people in the acute phase?

We play with rats because we believe we can learn from them … at our associated hospital, (Frasier) they’ve changed their acute protocols with patients as a result of this research, but we don’t have evidence to show them exactly what to do instead.

(Matt interjects to remind people about SCI Curecast and tell them that Dr. Magnuson talked with us for an hour.)

We’ve been able to show that restricting activity in rats prevents recovery. If you put them into a tiny cage, they can’t get better.

I’m a C4/5 ASIA A quad ….I had to pretty much invent my therapies because lots of us don’t get rehab at all. I don’t use a catheter and have full bladder control. I don’t think the window of opportunity is closed permanently. I think that epidural stimulation is one of the ways to open it. What do you attribute the closed window to?

Maladaptive plasticity ….for both complete transection and contusion, it matters if you do rehab immediately or weeks and weeks later.

Isn’t there good reason not to do any physical therapy type work very quickly after injury?

Ah, you’ve touched a nerve. There are some studies that suggest the tiny blood vessels in the cord are “leaky” — but those are mostly brain injury studies. They’re old studies, and the level of intensity that caused the “leaking” was very high. These old studies are the basis of the idea that we can’t do ANY rehab at all. We should forget about them.

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