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 and outpatient rehabilitation. This article will provide information about these three stages and also look at the different types of therapy that can be used at each stage.

Why Rehabilitation is Used to Help Spinal Injuries

As every spinal cord injury is unique, there are four main goals for rehabilitation:

  1. To improve the quality of life after injury
  2. To maximise independence
  3. To keep levels of activity as high as possible, despite reduced function
  4. 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
  • Psychologists
  • Recreational therapists
  • Rehabilitation nurses
  • Nutritionists

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 immobilised and realigned, if required, and respiratory aid is provided if there has been damage to the upper neck. The steroid methylprednisolone may be administered to decrease inflammation around the cord, known as spinal shock, and to reduce damage to the spinal nerve cells.

This steroids allows doctors to

  • 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 circumstance, and re-learns and how to perform day-to-day tasks, with the goal of regaining independence and returning home. Family members are encouraged to participate in these therapies to better understand the needs of their loved one and prepare for the next stage - life outside of the hospital.

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 centres.

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:

Physical Therapy

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 neurorecovery and, where possible, improve general motor skills. In addition, therapists may assist with breathing and, if required, help the patient to develop a coughing technique with the aim of keeping the windpipe clear.

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 dysreflexia, spasms and pain symptoms, such as chronic aches and pins and needles.

Physical therapy is often a communal therapy and plays an important role in encouraging the patient to engage with other injured people.

Occupational Therapy

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.

Psychological Therapy

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

Social workers assist families and patients by creating strategies that will cater for their future needs, such as home visits, arranging for assistive equipment and sourcing local community groups and resources.

Vocational Rehabilitation

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.

Recreational Therapy

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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If you have suffered a spinal injury in an accident that wasn't your fault, get in touch with our friendly and experienced solicitors today by calling 0800 054 6570. Alternatively, fill in our online contact form and we will get back to you.

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