Preventive measures in the tertiary care of spinal cord injured people.

There are complications of spinal cord paralysis peculiar to the extended care period. These may be motor skeletal, neurogenic, visceral and psychogenic. If practised regularly, prevention can be very effective in reducing the disability in all groups. Limb oedema, joint contractures, myasthenia and pain can be materially reduced by regular activity, maintaining joint mobility and the use of recreational motor skeletal activities. Urinary tract infection and decubiti can be largely eliminated by careful attention to anti-bacterial suppression and better hygiene, both personal and at home. Decubiti can be eliminated by regular skin care and eliminating friction and pressure. Most episodes of such complications can be effectively prevented and treated by the expert home visiting nurse. Social complications and drug abuse are areas of increasing concern. These can be kept to a minimum by regular assessment and, most importantly, when diagnosed early by the home visiting professional.