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| Principles |
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- If not followed by rehabilitatuion in an
experienced rehabilitation center, surgery of upper limb in
tetraplegia is unuseful and dangerous.
- Information of patient comes not only from the
medical team, but also from other patients.
- A good collaboration between physiatrists and
surgeons is mandatory.
- A good collaboration between physiotherapists and
occupational therapists is mandatory.
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| Preop |
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Preoperative physiotherapy is sometimes useful (not
systematically) :
- Passive Articular range may be increased
if needed
- Muscle to be transferred
may be reinforced if needed
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| Postop |
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| Each surgical procedure follows the same
postoperative pattern. |
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| First month postop = immobilization of the upper limb. |
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- Patient is in an electric wheelchair.
- His free joints are mobilised
- Controlled isometric contractions are started on
transferred muscle(s)
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| Second month postop |
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- Articular range of motion is progressively
recovered
- Transferred muscle is first exercised (physiotherapy),
then integrated in its new function (occupational therapy).
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| Third month postop |
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- Occupational therapy
- Motor reinforcement
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