Exercise after spinal cord injury is essential, but how can individuals exercise if they are quadriplegic and have extensive weakness throughout their bodies? Quadriplegic exercises consist mainly of passive range of motion and training of the upper body, although attention needs to be paid to the lower body as well.
Quadriplegia results from trauma to the neck region and leads to paralysis in your lower and upper extremities.
There are varying degrees of quadriplegia depending on what part of your cervical spine you injure. Likewise, the severity of your injury will determine whether you have partial (incomplete) or complete paralysis.
This article will share various exercises a spinal cord injury patient with quadriplegia can practice to improve their health and mobility. While the first few exercises could be completed by an individual with a complete SCI, the majority are targeted towards those with incomplete SCI’s.
Passive Range of Motion Quadriplegic Exercises
One type of exercise that all individuals with quadriplegia (complete or incomplete) can do is passive range of motion exercise.
Passive range of motion exercise requires no exertion of energy from the patient. A physical therapist, occupational therapist, or caregiver will be facilitating your movements and making sure that your joints move to their full extent.
Everybody has to start somewhere and passive exercise is a great way for people with quadriplegia to maintain joint flexibility and promote circulation. Passive range of motion exercises can and should be performed for both the upper and lower body.
If you can control some functions in your hands, wrists, and elbows, you can practice range of motion exercises without assistance (called ‘self range of motion’).
We have an article all about passive range of motion exercises that you can check out for a full-body workout and more details on the benefits of doing this type of exercise.
The best way to tell if you’re ready for more active forms of quadriplegic exercise is to be comfortable performing range of motion exercises on your own.
The Goal of Quadriplegic Exercises
If you have an incomplete injury and have some degree of control over your upper body, then the goal of quadriplegic exercises is to further improve this control over the upper body. By doing so, you can increase your independence with activities of daily living and use your arms and hands to assist with mobility of the lower body. That being said, we recommend doing exercises for your lower body as well, to whatever degree possible.
First, we recommend these practical hand exercises. They help you develop strength and dexterity in your hands and wrists through everyday activities so that exercising doesn’t seem like a chore.
Here are a couple more quadriplegic exercises that focus on developing upper body strength and mobility.
Don’t worry about your speed and focus on technique. Speed will build with repetition.
- Neck Tilts: Tilt your neck so that your left ear moves towards your left shoulder and then do the same for your right side. Important note: if you wear a neck brace of any kind or have been told you have “cervical spinal precautions,” do NOT perform this exercise and talk to your therapist and/or doctor about when you can try it.
- Shoulder Raises: Lift your shoulders up towards your ears and then bring them back down.
- Shoulder Rolls: Roll your shoulders forward and backward.
- Arm Rows: Put both arms straight in front of you and bend your elbows back.
- Arm Across Body: Bring one arm out across your chest and use your other arm to hold it there.
- Torso Twist: Gently twist your upper body to one side while keeping your lower body still. If you wear a back brace or neck brace of any kind or have been told you have “spinal precautions,” do NOT perform this exercise and talk to your therapist and/or doctor about when you can try it.
- Arm Raises: Raise your arm towards the ceiling as high as you can. But, if you have cervical spinal precautions, do not raise them any higher than shoulder-height.
- Arm Circles: Raise your arms to the side so that your body makes a “T” shape and move them in little circles forward and backward.
- Hallelujahs: Lift both arms out towards the sky, no higher than shoulder-height if you have cervical spinal precautions.
- Arm Flaps: Make that “T’ shape with your arms raised to the sides and move them up and down.
- Palm Flips: Put your arm out straight in front of you with your palm facing down and then flip it so that your palm faces up.
- Finger Clenches: Make a fist and clench all your fingers together. Then, open your hand and stretch out your fingers as much as you can.
Quadriplegic Exercises Emphasize Movement
The point of quadriplegic exercises is to move often. So long as you are following any precautions you’ve been given in terms of movement, it doesn’t really matter what you do as long as you’re using your body regularly.
There are lots of negative consequences of not moving your body such as blood clotting, pressure sores, and bone thinning.
If you can’t control your movements, it’s important to seek help and get someone to passively move your body for you.
This doesn’t mean you can idly sit around until they finish moving your body. You should be focusing on the movements too and be alert for any changes in sensation or control.
You’re basically trying to reinforce the connection between your brain and body through repetition. This can promote circuit regeneration and help build new pathways between the two.
Can Nerve Fibers in the Spinal Cord Regenerate?
For a long time, it was believed that the neurons in the central nervous system were unable to regenerate.
Fairly recently, scientists discovered that they could regenerate severed nerve fibers in mice and rats with complete spinal cord injury by “reactivating the genetic program for axons to grow, establishing a permissive environment for the axons to grow in, and creating a chemical slope that marks the path along with axon are encouraged to regrow.”
They explained the phenomenon with the following analogy:
“If nerve fibers were trees, then the terminal branches of the axons can be viewed as the tree’s branches. If the main branches of the tree are cut, little branches may sprout spontaneously along the remaining trunk of the tree. But the cut branches do not grow back.”
The axon regrowth was able to transmit electricity, but because the mice and rats weren’t participating in physical rehabilitation training, they remained paralyzed.
This has yet to undergo human trials but shows lots of potential for reestablishing connections between the brain and body.
The Power of Repetition
Spinal cord injury recovery heavily relies on spared neural pathways because they are capable of neuroplasticity.
Neuroplasticity is the spinal cord’s ability to rewire itself and strengthen functions weakened by injury. Consistently repeating weakened movements helps stimulate neuroadaptive changes in the spinal cord and strengthen new connections.
Hopefully, this article helped you understand the importance of movement for recovering from quadriplegia and that functional improvements are possible after spinal cord injury. Good luck!