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Advances in medicine now mean that those who have sustained a spinal cord injury have both an increased chance of survival and an improved ability to lead a fulfilling life through the rehabilitation process.
This process follows three main stages: acute rehabilitation, inpatient rehabilitation
Why Rehabilitation is Used to Help Spinal Injuries
As every spinal cord injury is unique, there are four main goals for rehabilitation:
- To improve the quality of life after injury
- To maximise independence
- To keep levels of activity as high as possible, despite reduced function
- To facilitate neurorecovery when and where possible
Each rehabilitation programme is tailored to the individual, their specific injury and their personalised goals. Typically, the programme will involve several specialists who combine counselling, emotional support, physical therapy and skill-building exercises.
These specialists can include:
- Physiatrists or physical medicine rehabilitation physicians, who usually lead the rehabilitation programme
- Social workers
- Physical and occupational therapists
- Recreational therapists
- Rehabilitation nurses
Charities and support organisations may also be involved to work together with the specialists, and the injured person, to work towards the goal of improving daily life.
Stages of Therapy
There are three main stages of any typical spinal cord injury rehabilitation:
Stage 1: Acute Rehabilitation
Acute rehabilitation is administered as soon as medical attention can be given to the injury.
The spine is
- Complete a full neurological assessment
- Diagnose the severity of the injury
- Predict the most likely extent of recovery
Following this assessment, the patient then progresses to stage two.
Stage 2: Inpatient Rehabilitation
At this stage, the primary focus is to improve strength and function in the legs, the arms, and to improve mobility and physical communication skills.
As function improves, the rehabilitation team will then go on to address wider issues such as bowel and bladder training, exercise, sexual function, diet and nutrition, and general daily living.
During this stage, the patient learns how to adapt to their new
Stage 3: Outpatient Rehabilitation
Once the patient is discharged, the team continues to work together to improve all aspects of the injured person’s life. Outpatient rehabilitation is conducted either at home or at specially designed medical
Sessions can vary from weekly, daily or multiple times a day, depending on the person’s specific needs. The aim is to gradually reduce the sessions as the patient’s abilities improve, encouraging them to live independently.
Types of Therapy
As each injury is as unique, the types of therapy with which the patient is treated can widely differ. Detailed in this section are the most common types of therapy currently used by specialists:
A therapy plan will be created that takes into account the level of injury sustained, the nature of the injury, and the immediate and long-term impact of the injury on the individual. Each plan is tailored to the patient and will be developed as rehabilitation progresses and goals are achieved.
Physical therapists work to strengthen muscle groups, improve
As the patient improves, the focus on mobility rehabilitation may widen to include treadmill and gait training for people with incomplete spinal cord injuries.
Coping strategies may gradually be introduced to deal with autonomic
Physical therapy is often a communal therapy and plays an important role in encouraging the patient to engage with other injured people.
There are two types of occupational therapy that a patient might receive - inpatient and outpatient.
With the aim of promoting independence and preparing the patient for life outside of the hospital, inpatient occupational therapy focuses on improving skills such as balance, feeding, techniques for self-grooming, dressing, strength coordination and how to use adaptive equipment where needed.
Outpatient therapy continues to develop these skills, but also continues to monitor and develop new targets as the patient progresses, such as focusing on posture, motor function and changes in sensation.
Emotional support is a vital part of rehabilitation from the very beginning of the patient's journey to better help them and their family come to terms with the life-changing nature of the injuries.
By addressing well-being and emotional stability, the therapist will hope to help the patient adapt to their new life, and treat depression if it arises.
Social workers assist families and patients by creating strategies that will cater
This rehabilitation looks at the patient's physical and mental abilities and assesses whether they are strong enough to return to work. This may later involve helping the person to find work and ensuring that necessary adaptations are in place at the workplace.
For those who are unable to return to work, recreational therapy programmes are available. These include sports that help to encourage both an active mind and body, as well as helping social interaction with other people in a similar situation.
No matter the severity of the injury, rehabilitation required after a spinal cord injury is lengthy and requires a lot of patience and hard work.
A very strong rehabilitation team that works together with a committed patient can make significant gains in helping the injured person come to terms with their new life and embrace their future positively.
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