Incomplete quadriplegia is a condition wherein some degree of weakness in all four extremities or paralysis occurs. The extent of preserved mobility depends upon the severity of the spinal cord injury sustained by the patient.
About 47% of all spinal injuries result in incomplete quadriplegia. This makes the condition the most common form of spinal cord injury. However, there is a silver lining. Many individuals living with such disabilities learn to live successfully with their conditions. They adapt and manage their sensory and motor deficits effectively to improve the quality of their lives.
What is the Difference between Tetraplegia and Quadriplegia?
The terms define the same medical condition; tetraplegia and quadriplegia can replace one another. The prefix ‘quadri’ comes from Latin, and ‘tetra’ comes from Greek, both of which mean ‘four.’ The suffix ‘plegia’ stands for ‘paralysis.’ These terms together encompass paralysis affecting all four limbs.
Speaking in relation to cases of spinal cord injury, the definition of quadriplegia further extends to include paralysis of the torso. The basis for this phenomenon lies in portions of the spinal cord energizing the arms above those energizing the trunk and legs.
Because of this fact, should these portions be severed, signals from the brain cannot pass through the damaged portion of the spinal cord and, hence, cannot reach segments lower than the level of the injury.
Moreover, in injury to the spinal cord, the sensory messages of the body cannot pass around the damaged portion of the spinal cord to reach the brain. For this reason, quadriplegic patients suffering from injury to the spinal cord generally do not have feelings in their arms, trunk, and even their legs.
The severity and expression of quadriplegia can indeed vary a lot depending on the exact location and the severity of your spinal injury. While, for instance, some people might still have typical arm function and only experience some weakness in the hands, other individuals may also develop paralysis from the neck down. Although the functionality is extremely different, both these cases fall under quadriplegia.
What Is the Cause of Partial Quadriplegia?
Partial quadriplegia is most often the result of damage to the cervical or neck portion of the spinal cord. That area of our spine is critical because it is from that location that motor and sensory nerves reach our neck, shoulders, arms, and hands. Possible incidents that may cause this are motor vehicle accidents, sports injuries, or falls.
The extent of the effect that your body will face largely depends on the severity of the injury. This is because any signals either to the brain or from it are impeded by the damage done to the spinal cord to affect all functionality from below the point of injury.
For instance, if the injury to your spinal cord is at the C2 level, then it would impact all movements from the neck down. On the other hand, if there is damage at the L1 section, it will most probably affect the lower body functions only, and everything above the injury site will keep working normally.
Complete vs. Incomplete Quadriplegia
Quadriplegia may be complete or incomplete; this is the division that defines severe spinal cord injury. Advanced imaging techniques such as CT scans or MRIs will define these.
An incomplete injury, of course, means partial damage to the spinal cord. There are still avenues through which the communication route, originating above the brain to below the injury site, functions. These surviving neural pathways, or “connections,” hold the key to any level of recovery.
They can use the so-called neuroplasticity, the brain’s potential to rebuild its connections and adapt. Thus, people with incomplete quadriplegia can usually activate those preserved connections to retrieve partially lost capabilities or further develop them.
It should also be recognized that incomplete quadriplegia may indeed vary from one individual to another. Some injuries might be less serious, but they still retain a little mobility and sensation around or below the injury site. As soon as any degree of neural connections remains, we refer to this as an incomplete spinal cord injury.
Conversely, a complete injury indicates that no neural connections at the site of injury survived. Such injury disconnects the nerve impulses, which carry messages to and from the brain and cannot be transmitted beyond the injury site. Any person with a complete spinal injury will completely lose all motor or sensory functions below their injuries since all of the connections are severed.
Because these severed connections cannot regenerate, the chances of recovering lost functionalities are slim. Rehabilitation for complete quadriplegia, therefore, aims at the optimization of remaining unaffected functions, compensation for the lost ones, and prevention of further complications below the injury.
Can Complete Quadriplegia Evolve into Incomplete Quadriplegia?
Unfortunately, the neurons in our central nervous system cannot regenerate. Therefore, once the spinal cord is physically damaged, the condition becomes permanent. While it is true that a completely paralyzed area cannot suddenly become partially paralyzed, there are cases where initial diagnoses may incorrectly assess an incomplete spinal cord injury as complete.
Picture this. Immediately following a spinal cord injury, the subsequent swelling of the spinal cord may impede the necessary blood flow to create a condition known as spinal shock. This alarming-sounding term is actually the complete loss of your reflexes and motor control below the point of the injury.
But the saving grace is that this condition does not last. As the swelling reduces, you can begin regaining some of the lost functionalities. The time for which spinal shock remains differs from days to months. A person suffering from a spinal cord injury may just find out that his/her case is not as bad as it seemed in the first place.
Practical Recovery Goals for Those with Incomplete Quadriplegia
Those with incomplete quadriplegia often receive physical and occupational therapy. In physical therapy, the emphasis is on maximizing mobility. It accomplishes this through stretches, exercises that enhance the range of motion, and strength training. It further helps enhance balance when sitting and standing, identifies the right mobility aids like walkers, and trains specific muscles to boost movement.
Occupational therapy has a different emphasis altogether. Its aim is to enable a patient to regain their independence in accomplishing the activities of daily living. Activities such as being able to dress themselves, bathe themselves, and utilize the toilet will fall into this category.
Beyond this, it also enables the patients to regain mastery of more complex skills like cooking, driving, and resuming work. Such therapy is achieved by splinting, sensory coaching, rehabilitative exercises, and adaptive techniques and devices.
In incomplete quadriplegia, the general line of treatment would be to first focus efforts on facilitating improvement in the upper part of the body before proceeding to the lower. The general trend is, however, to increase mobility altogether. Hence, any movement, no matter how small, is highly encouraged.
How to Recover Functions in Incomplete Quadriplegia
People with spinal injuries could recover functions lost by continuing physiotherapy at least two levels below their injury mark. The kind of injuries is different, and even patients with similar levels and injury severity can vary in recovery. This is why personalized rehabilitation programs, which you can get from interactions with occupational and physical therapy teams, are very important.
Breaking down your long-term recovery goal into smaller, specific goals is a great method of monitoring your progress and keeping you motivated. It’s crucial to remember that people with a higher-level injury may initially have more functional challenges. Still, over time, they can achieve a great deal. Goals that can be set may vary considerably depending on the injury level and severity.
Sample recovery goals of a person with incomplete quadriplegia could include the following:
- Improvement in Hand and Arm Use: Activities for the program may include lifting minimal weights, doing dexterity drills, and practicing fine motor activities such as buttoning a shirt or using utensils. These exercises are also going to build better coordination and precision.
- Improvement of Core Stability and Balance: This will be important when sitting and standing without support. Exercises may include balance training, core strengthening exercises, and training in transferring from one position to another, for example, sitting to standing.
- Gait Development and Mobility: When possible, efforts can be made to transition to walking. The efforts will include gait training, using an assistive device such as crutches or a walker, and technology, including robotic exoskeletons that support ambulation.
- Strengthening Respiratory and Cardiovascular Function: Breathing exercises are as important as cardiovascular exercises for those with limited mobility to strengthen the lungs and support the heart.
Verdict
Rehabilitation can be very tedious and requires a lot of patience and persistence, as progress may be very slight and gradual. Support from family, friends, and health professionals can do much to motivate and encourage the person in their recovery.
Incomplete quadriplegia patients often take huge leaps in regaining control over many aspects of their daily lives by offering themselves celebrations of minor accomplishments with a focus on long-term goals.