In the earliest stages of the paraplegia, the treatment is surgical, supportive and psychological. As soon as the physical conditions permits the patient should be encouraged to participate in mental and physical exercise through activities in bed and outside.

                 The earliest objective is to conquer depression caused due to the disease, which is proportional to the extent of disability. Since the handicap is partly psychological,  introspection,  which  deepens  depression ,  must be minimized. To this and all  the  forces  of  mental  hygiene  should  be  applied  and  the diversion applied  by  an  absorbing  self-motivating  interest  is  frequently rewarded. A wide range  of  O.T. activities  can  be  given to both sexes which are appealing to all ages and can  be  accomplished  In  the prone  position  on  the  stryker  Frame (a type of frame  used  for  paraplegics) and these alternated with periods of rest in supine position. Keeping in mind the limitations of future activity in either a wheel chair or crutch existence. Both a vocational and prevocational possibilities may be explored to an advantage at this stage.

                         The ultimate objective for all the paraplegics is independence. Physical independence is the fundamental to all other types and aspects of independence. This means a great strength in upper extremities to ambulate with the help of crutch and bear whole of the body weight on the upper extremities during walking with crutches. The strength in the shoulder gridle will also facilitate walking with crutches. The strength in the shoulder gridle will also facilitate training.

                           The O.T. aims are :

        1. To give psychological relaxation.
        2. To overstrengthen upper extremities and strengthen lower extremity.
        3. To increase range of movement if limited in legs.
        4. To improve co-ordination in lower extremity.
        5. To prevent pressure - sores.
        6. To provide splints, calipers and braces if need arises.
        7. To give gait training
        8. To give A.D.L. training
        9. To give prevocational and vocational training.
       10. To give recreational therapy.
       11. To improve sitting and standing tolerance.
       12. To socialize the patient in a group and then in community, e.t.c.
       13. The home care program.

        Mainly it is the re-education of the paraplegics to recover lost functions with or without assistance.

1. To give psychological relaxation:
                         This is the session of rapport in between the paraplegic and the therapist. The therapist tries  to  allay  anxieties  and  worries.  These  patients  are often depressed as they think of their disease and their family. The best thing is to make  the  patient  accept  the  handicap  and  later  may  take  an  optimistic  view  of the  life  so  crippled.  They  should  not be made to feel helpless and disgusted because this may demoralize the patient badly. They should always be encouraged to be happy and cheerful.
                Mostly the patient develops fear about health, appearance, sexual functioning,  employability  and  his separation and loss of family status and community. This may be compensated by denying the problems to cope up with the situation. When he recognizes the problem, he is depressed which is very normal reaction  of  grief  of  loss of function. The family must be made to under stand the needs of this patient in term of prognosis and his future life problems. This can be prevented if he is visiting the rehabilitation center where he sees the other paraplegics adjusted to life. You may even show the photographs of the patients who have very nicely adjusted to their handicap.
               The patient  can  be  made  to adjust  to his life by introducing those activities, which are related to his life before disease. Introduce only those activities, which the patient can do so that a sense of confidence prevails in the patient's mind. This way he  can be motivated highly and regains feeling of worth and hopes for better future. Give  ample of opportunities for social group interactions to take out their feelings, which give them confidence in themselves. To assist the patient in psychological adjustment, the entire rehabilitation staff should encourage the patient to take  an  initiative  or  an  active part  in his  rehabilitation  planning , and furnish him with real problems, which come across when patient tries to take his status place in his family and community. Patient must set realistic vocational goals to make total rehabilitation successful.
              If O.T. fails to meet the psychological needs of the patient and later may react with passivity because of fear of dependence and failure. He may react with aggression and hostility.

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