Quadriplegia

[Syntinen Laulu]

Does anyone have experience of massage for clientswithquadriplegia/cerebral palsy? Any tips for massage of someone in their own bed, not height adjustable, would be useful. Thanks

 

[staffieredspain]

imo, sorry I don't have personal experience but I assume we are talking about a client with a degree of paralysis, spacicity, flacidity etc. Ilooked up in Ruth Werner - A Massage Therapists Guide to Pathology - which is a superb bookand always my first place to look.

If I summarize - they are similar, but not the same conditions - Quadriplegia being associated with Spinal Cord Injury, whereas Cerebral Palsy is associated with prenatal, birth or early infancy. They both can respond well to massage - with a strong caveat that there should be nerve sensitivity in the area of massage and good feedback with the therapist to avoid any unintentional damage with massage. Also, especially with SCI you need to be aware of underlying pathologies that may be exacerbated by massage (what caused the SCI - what is the state of healing etc )

As always Ruth Werner is conservative, but I always like to understand the conservative viewpoint before making any treatment decisions. Also typically in either of these cases there will be existing medical care, and it would be good to discuss and get agreement (perhaps written) on massage treatment before starting - again conservative but probably sensible.

Having said that, massage can be hugely beneficial so you need to investigate ways that you can use massage with this client to bring benefits to them. I certainly would not rule out massage just because this sounds like a tricky condition. This sounds like a case where, initially at least, massage should be light and gentle- not deep and strong, perhaps incorporating PMtechniques if you are comfortable with them.

In terms of practicalities - I just think you will need to adapt to the client, and be very careful of your own body mechanics. I would guess that if the client cant move or you cant move the client then its the therapist that will need to change height etc. You might need to sit, kneel (with padding), stand, bend (from the knees) etc.Again no personal experience, but probably good to talk to the care team on that front.

You need to make your own assessment and decisions,and I would also suggest being even more diligent than normal with your treatment notes (just in case).

So, sorry I cant give direct experience, but I hope this helps,

InTouch

 

[Suffi]

Please make sure of your 'body mechanics' when treating people in their own beds. I've been in the business for nearly 30 years, and so far have been very lucky in avoiding injury. Some years ago I was invited to treat a client with quadriplegia. I said that I needed to assess the situation first, so went for an initial consultation. There was no way I could have treated himin his own bedwithout doing myself harm. All I could offer was facial massage, which was the only part of him I could 'comfortably' get to. Following the consult, I had a meeting with his doctor andhome care team, and they managed to have a treatment couch supplied, and were able to get him onto this for me, using hoists. I was not able to treat his back, as he had breathing difficulties, sohad to enlist the help of the'crew' to get him sidelying to do spine work when he needed it. I saw him regularly over several years, until I moved out of the area.

I treated a young girl with cerebral palsy - she was the daughter of a friend and an absolute delight. However, she had the concentration span of a fly (her mothers words, not mine!) so all the treatments were extremely short initially - around 10/15 minutes. Over a number of weeks we built up to 45 minutes. She loved any form of touch, and relaxed very easily. She had problems with sinus pain, so I did intra-oral work. After working in her mouth, I would blow up the latex glove and give it to her to play with, while I worked on her abs, and legs! To keep her in place on the couch, I got very creative with the drapes - i am not sure I would have been happy treating her on a static couch- mine is electric, so I was able to keep it quite low, and sit on my stool to treat her - however, she never fell off! I treated her from the age of 5 - 9, then she moved to a different country.

 

[NYMAMA_2010]

Thanks for the replies. I haven't seen the Ruth Werner book, but it sounds useful so I'll have a look for it.
I will be talking to the support team again next week & am due to visit so I can check out the practicalities properly. I think the carers will be glad of any massage that I can give, & I'll certainly be watching out for my posture! Thanks again.