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Paraplegic Rehabilitation in South Africa

Acute Management II

Physiotherapist

The physiotherapist assessed motor, sensory, and respiratory function; muscle testing according to the Oxford Scale, and sensory testing according to neurological segmental innervated levels. The results confirmed that Zamani had sustained a T11 complete spinal cord lesion.

Chest Evaluation

Physiotherapists in South Africa perform a chest evaluation as well as respiratory treatment.

Zamani had good chest expansion on palpation.

Ascultation

Good air entry left and right.
No abnormal sounds present.
Good independent clear cough.

The physiotherapist saw Zamani twice a day to evaluate his chest. Deep breathing exercises were given and no further treatment was deemed necessary.

Passive movements were done daily to maintain range of movement and to improve circulation. Due to the T12/L1 dislocation, hip flexion, abduction and adduction was only done to 56 degrees to prevent any potential movement at the fracture site.

No strengthening exercises were given at this stage due to severe lumbar pain as well as the instability at the fracture site.

The treatment time was used to develop interpersonal skills with the patient. The same physiotherapist treated Zamani from admission to discharge.

Occupational Therapy

Interpersonal relationships are established at this stage. The OT interviewed the patient and informally explained the injury to the patient and the family. The OT visited Zamani regularly until he could get up in his wheelchair and start the next phase of rehabilitation.

Social Worker

The social worker met Zamani and his family and explained her role in Zamani's rehabilitation. She initiated an interpersonal relationship and assessed his social, home, and financial circumstances. He was single and had no dependents. Prior to his accident he lived with his mother and sisters in a single-story house. He used public transport daily to travel to the university; he did no part-time work. Zamani wanted to return to the university.