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Living With Paraplegia: What to Expect and How to Adapt

what to expect when living with paraplegia

While living with paraplegia can require major adjustments, it can also be an extremely rewarding experience.

With the right support and management, individuals with paraplegia can have very independent and productive lives.

In this article, we’ll discuss how to cope and establish a new normal after spinal cord injury.

Understanding Paraplegia Recovery Outcomes

Paraplegia recovery outlook depends on many factors. Some (like the intensity of rehabilitation) can be controlled while others (such as the severity and level of injury) cannot.  

Because everyone experiences paraplegia differently, it’s essential to take a personalized approach to recovery and try not to compare recovery outcomes. What works for one person won’t necessarily work for another.

It’s also important to understand that individuals with paraplegia can improve years after their spinal cord injury. Thanks to neuroplasticity (the spinal cord’s ability to rewire itself), undamaged pathways in the spinal cord are always capable of learning new functions and adapting.

The best way to promote paraplegia recovery after an incomplete spinal cord injury is to practice highly repetitive, task-specific movements. This will help the spinal cord perceive a demand for that movement and encourage neural rewiring and strengthening of those connections.

Up next, we’ll discuss how occupational therapy can help individuals with paraplegia cope and improve their mobility.

How Occupational Therapy Prepares You for Living with Paraplegia

Occupational therapy is an essential part of paraplegia rehabilitation because it focuses on preparing individuals for the transition back to everyday life.  

It’s usually not until you get home that the challenges of living with paraplegia start to sink in.

Don’t be hesitant to ask for help when you need it, but also make an effort to practice the adaptive techniques you learned in occupational therapy. Individuals with paraplegia have fully functional hands and arms, so you can still have lots of independence.

In the following sections, we’ll discuss how occupational therapy can help individuals with paraplegia care for themselves at home, return back to work, and drive again.

Adapting at Home

spinal cord injury patient practicing adaptive techniques for living with paralegia

While physical therapy for paraplegia recovery focuses on improving mobility through exercise, occupational therapy takes a more holistic approach by practicing activities of daily living.

Activities of daily living include grooming, bathing, toileting, transferring, feeding, and dressing.

Learning new ways to perform everyday activities can involve the use of adaptive tools to help make up for lost functions.

For example, individuals with paraplegia may learn how to use:

  • transfer benches to get in and out of the shower
  • wheelchairs or walkers for greater mobility
  • leg lifters to get in and out of bed
  • shower hoses to reduce the risk of slipping while bathing

Similarly, an occupational therapist can visit you at home and suggest home modifications that can make living with paraplegia easier. For example, those with severe paraplegia may be unable to travel up and down the stairs. In such cases, installing ramps or a stairlift can help make the home more accessible.

Returning to Work or School

man living with paraplegia and working

A major goal of occupational therapy for paraplegia is to help you live as normally as possible, which often involves going back to work or school.

An occupational therapist can help you understand your rights in the workplace and at school.  Laws like the Americans with Disabilities Act and the Individuals with Disabilities Education Act (IDEA) are designed to help individuals with paraplegia get the accommodations they need to succeed.

Examples of reasonable accommodations include:

  • Ensuring a wheelchair-accessible environment
  • Authorizing a more flexible schedule
  • Supplying adaptive equipment
  • Providing extra time to complete assignments

If you have a more sedentary job, going back to work shouldn’t be too difficult. However, it is your responsibility to ask for accommodations.

If you have a more active job and it isn’t realistic for you to return, consider meeting with your current employer and asking about other positions within the company that you might be a good candidate for.

If you need to completely start from scratch, seek a vocational rehabilitation program to help assess your skills, provide helpful resources, and present potential job opportunities.

Learning How to Drive Again

man with paraplegia learning how to drive again

Another major lifestyle adjustment that an occupational therapist can help you out with is learning how to drive with paraplegia.

This will require the help of an occupational therapist who is certified in driving rehabilitation. They will help evaluate your functional abilities to make sure you can safely get on the road again, prescribe car adaptations, and teach you how to use them.

Driving with paraplegia is possible because individuals have normal upper body functions. As a result, they can utilize hand controls to compensate for limited mobility in the legs.

Now that you understand how occupational therapy can help prepare individuals with paraplegia for daily life, let’s discuss other ways to cope.

Helpful Tips for Living with Paraplegia

woman in wheelchair at cafe

Living with paraplegia can be overwhelming at first, but as long as you’re open to change and continue to practice adaptive techniques, it does get better.

Here are some tips to help you cope physically, socially, and psychologically:

  • Avoid compensatory strategies unless absolutely necessary. While compensatory strategies like using adaptive tools can make it easier to manage life with paraplegia, it can also slow down your recovery. Many people become overly-reliant on compensatory strategies and give up on performing the repetitions they need to promote neuroplasticity.  
  • Attend psychotherapy. Living with paraplegia is just as much a mental challenge as it is a physical one. Psychotherapy can help you better understand your frustrations and suggest effective ways to cope.
  • Participate in physical therapy regularly. A physical therapist will assess your functional abilities and create a personalized exercise regimen to improve your mobility.
  • Join a support group. Joining a spinal cord injury support group can help connect you to people that understand what you’re going through. By sharing experiences, you’ll learn new ways to manage complications and understand that you’re not alone.
  • Be patient. It takes thousands of repetitions to stimulate neuroadaptive changes in the spinal cord, so trust in the process and keep practicing!

Living with Paraplegia: Key Points

Through occupational therapy, individuals with paraplegia can learn how to care for themselves at home, return to work, and drive again.

Many people with paraplegia learn how to improve their lower body functions through highly repetitive, task-specific training. By consistently practicing weakened movements, individuals can stimulate adaptive changes in the spinal cord.

Hopefully, this article helped you better understand what living with paraplegia can involve and how to cope. Good luck!

Photos from top to bottom: iStock/ViewApart/AnnaStills/vadimguzhva/AndreyPopov/Antonio_Diaz

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