SCI Patients Improve Their Chances with the Tutor System

THE NATION featured this report by Carol Aloysius about SCI difficulties in Sri Lanka.

Spinal cord injuries are on a dramatic rise in Sri Lanka caused by the increase in construction industry work, road accidents, domestic and industrial accidents as well as war injuries. Every year around 1500 – 2400 patients are admitted to hospitals with Spinal Cord Injuries (SCI) and every four hours, one person dies without proper treatments. This year alone, in the first three months, there were 175 victims of SCI admitted to the NHS, orthopedic surgeons said at a media seminar held at the Health Education Bureau on Thursday. The seminar was to discuss the forthcoming 10th Asian Spinal cord Network ( ASCON) on total care for patients with SCI. Over 80 million people suffer from Spinal Cord Injury every year globally according to the WHO.

“Our hospitals are still not properly equipped to handle such patients to ensure the best outcomes. Our objective is to develop a regional network and set up a ward with special beds in all hospitals island wide for SCI patients in the near future,” Dr. Anil Dissanayake, Director of Youth, Elderly & Disabled said. At present, the country’s only specialized SCI unit at Ragama. SCI patients are still waiting for approval to build a badly needed residential home for those who cannot return to their own homes due to lack of facilities such as special toilets, beds etc, a spokesperson from the hospital said.

Dr. Narendra Pinto, Consultant Orthopedic & Trauma Surgeon NHSL noted that trauma from an SCI was the leading cause for hospital admissions with the victims being mostly young males between 25- 45 years at the peak of their productivity.” Injuries could be minor, major or fatal and caused by occupational, home environment, war in juries, assaults, recreational activities or sports. “More injuries occur during vacations and on trips, as well as during the festive seasons in April and December. Falling from heights such as trees, construction buildings, roofs, or slipping on the floor or diving into shallow water could injure spine. Once the spine is injured, it cannot be cured completely . We can only minimise the damage and optimise rehabilitation to avoid further complications”, he informed.

Emphasising his colleague, Dr. G.L Punchihewa President, Sri Lanka Orthopedic Association said, “There are no miracle drugs for spine injuries. If someone meets with a sudden accident, care should be taken to avoid a second accident while transporting that patient. Call 110 for help and a rescue team of trained personnel will be at the accident site within 10 minutes anywhere in Colombo.”

Of those admitted to hospital, he noted, over 55% were cervical spine injuries; 15% injuries thoracic spine injuries and 15% lumboscaral spine injuries.” These injuries could result in fracture, dislocation or nerve injury which may result in permanent disability depending on the level and severity of the injury.

Dr. Lilani Panangala, Consultant at the Ragama Hospital, said that the Ragama Rehabilitation Hospital was the only specialised SCI unit in Sri Lanka with institutional rehabilitation capacity for 150 persons per year, and beds available for 120 patients. At least 1350 patients with SCI do not receive p roper rehabilitation and over 75% percent die within 18 – 24 hours from complications like pressure, sores etc, she informed. She also appealed to authorities to expedite approval for building for the badly needed residential centre to have proper care facilities for SCI patients who are unable to go back home.

The HandTutor, ArmTutor, LegTutor and 3DTutor are devices that are FDA and CE certified and are being used in leading U.S. and foreign hospitals.

These innovative devices implement an impairment based program with augmented feedback and encourage motor learning through intensive active exercises. These exercises are challenging and motivating and allow for repetitive training tailored to the patient’s performance. The system also includes objective quantitative evaluations that provide the therapist information to customize the most suitable rehabilitation program to the patient’s ability.

They have had success in improving movement of the hand, wrist, elbow, knee, ankle, foot and other joints of the body following Spinal Cord and other traumatic injuries. The devices have been effective for post stroke victims as well as for those suffering from Cerebral Palsy, brain injuries, Apraxia, MS, Parkinsons and other movement disabilities. Intensive active exercise can reduce the rate of deterioration and this is what the ”Tutor” devices provide.

The system is also used in physical therapy clinics as well as the patient’s home with tele rehabilitation. The ”Tutors” are suitable for adults and children.