Post-Accident Rehabilitation: Addressing Concerns and Treatment Options

Q: Post-Accident Rehabilitation: Addressing Concerns and Treatment Options

Dear Mr. <br>J：<br>You have truly worked hard for the health of your family, putting in considerable effort and doing your homework. <br>When it comes to trauma patients, the first step is to treat the injury; once the disease is treated, all problems are resolved. <br>However, r

Post-operative issues following a car accident?

Thank you very much, Dr.
Lin, for carefully addressing my concerns.
I understand that many medical issues require cooperation between the patient and the physician to achieve the best treatment outcomes.
I later explained the situation to my elder family member, but considering their advanced age, they are reluctant to undergo surgery or any complex treatments, and I cannot force them to pursue further management.
As a child, I still feel anxious and scared about such situations, and with no other options, I have to reach out to the doctor again.
1.
I would like to inquire about the potential sequelae or the extent of deterioration if no further treatment or surgery is pursued in this situation.
2.
Currently, my elder family member is undergoing passive rehabilitation and performing towel pulls from behind, along with some active movements and the use of a low-frequency electrical stimulation device.
Are these rehabilitation activities sufficient? Are there specific movements or angles that should be avoided or emphasized?
3.
Regarding daily activities, my mother reaches for items on high shelves and practices dance movements that involve swinging her arms to lift them.
Is this acceptable? Can she safely use and move her arms in daily life (for example, handling light objects or doing simple household chores)?
4.
Additionally, for daily care, I plan to encourage my family member to consume more calcium-rich foods.
Are there any other recommendations or precautions regarding this situation?

Mr. J, 30~39 year old female. Ask Date: 2021/04/23

Dr. Lin Ruixiang reply Rehabilitation

Dear Mr.
J:
You have truly worked hard for the health of your family, putting in considerable effort and doing your homework.
When it comes to trauma patients, the first step is to treat the injury; once the disease is treated, all problems are resolved.
However, reality often presents many challenges, and not everything goes as planned.

To return to the main topic, rehabilitation is primarily divided into the functional recovery phase (also known as the golden treatment period) and the functional maintenance phase.
Your family member should be categorized under the latter, with treatment goals focused mainly on pain control and maintaining range of motion.

Now, to address your questions:
1.
The bones and muscles of the upper body are less likely to experience disuse atrophy compared to the lower body.
In rehabilitation considerations, the focus should still be on maintaining range of motion and controlling pain, so there is no need to worry excessively about disuse atrophy leading to severe complications.
2.
The current focus of rehabilitation remains on maintaining range of motion and controlling pain.
Generally, exercises and electrical therapy can meet these needs, especially the towel pull exercise performed behind the back; if done correctly, it can effectively maintain range of motion.
3.
To answer your question, we need to understand two terms: concentric exercise (where the direction of force aligns with the direction of movement) and eccentric exercise (where the direction of force does not align with the direction of movement).
For example, swinging the arms is a concentric exercise, which is less likely to cause damage to bones and muscles.
Light weights and simple household chores typically fall under concentric exercises and are permissible.
Conversely, eccentric exercises, such as striking an object that rebounds or chopping motions, should be avoided as they are more likely to cause injury.
4.
Calcium supplements and light weight exercises are fundamental and suitable for both fracture and non-fracture patients.
Additionally, sun exposure (5-10 minutes) not only benefits bone health but also helps prevent sarcopenia and can improve mood.
If there are difficulties in implementation, direct supplementation of vitamin D is also effective; however, it is important to note that vitamin D is fat-soluble and can accumulate in the body if taken in excess, so it must be used according to the recommended dosage.
Sincerely,
Lin Ruixiang
Hualien Hospital, Ministry of Health and Welfare

Reply Date: 2021/04/23

More Info

Post-accident rehabilitation is a critical aspect of recovery, especially for individuals who have sustained injuries from incidents such as car accidents. Your concerns regarding the potential long-term effects of not pursuing further treatment, the adequacy of current rehabilitation efforts, and daily living activities are valid and deserve thorough consideration.

1. Long-term Effects of Not Pursuing Further Treatment: If further surgical intervention is not pursued, the potential for long-term complications largely depends on the nature and severity of the initial injuries. In cases of soft tissue injuries, such as rotator cuff tears or tendonitis, there may be persistent pain, weakness, and limited range of motion. Over time, these issues can lead to compensatory movements that may cause additional strain on surrounding muscles and joints, potentially leading to arthritis or chronic pain syndromes. It is essential to monitor symptoms closely and maintain open communication with healthcare providers to address any changes promptly.

2. Adequacy of Current Rehabilitation Efforts: Engaging in passive rehabilitation exercises, such as towel stretches, and utilizing modalities like low-frequency electrical stimulation can be beneficial. However, it is crucial to ensure that these exercises are tailored to the individual's specific needs and capabilities. A physical therapist can provide a comprehensive assessment and develop a personalized rehabilitation program that includes both passive and active exercises. It is also important to avoid movements that exacerbate pain or discomfort, particularly those that involve heavy lifting or overhead activities until cleared by a healthcare professional.

3. Daily Living Activities: Regarding daily activities, it is generally safe for individuals to engage in light tasks, such as lifting lightweight objects or performing simple household chores, as long as they do not experience pain. However, caution should be exercised with activities that require significant shoulder or arm movement, such as reaching for high objects or performing vigorous motions like dancing. It may be beneficial to modify these activities to avoid strain and ensure safety. Encouraging the use of proper body mechanics and ergonomic techniques can help prevent further injury.

4. Nutritional Considerations: Ensuring an adequate intake of calcium and vitamin D is essential for bone health, particularly in individuals recovering from musculoskeletal injuries. Foods rich in calcium include dairy products, leafy greens, nuts, and fortified foods. Additionally, incorporating weight-bearing exercises, as tolerated, can help strengthen bones and improve overall physical function. It may also be beneficial to discuss with a healthcare provider or nutritionist about potential supplements if dietary intake is insufficient.

In summary, while it is understandable to be apprehensive about the recovery process, maintaining a proactive approach to rehabilitation and daily activities can significantly enhance recovery outcomes. Regular follow-ups with healthcare providers, adherence to rehabilitation protocols, and a focus on nutrition will contribute to a more favorable prognosis. If there are any changes in symptoms or concerns about the recovery process, it is crucial to seek medical advice promptly.

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