Spinal Cord Injury Rehabilitation Program

Introduction:

Individuals who survive a spinal cord injury are most susceptible to facing medical complications like paralysis (loss of movement in certain body parts), bladder and bowel dysfunction, chronic pain, and an increased risk of developing heart and respiratory issues. Successful recovery relies on how well these conditions are handled daily. While neurological rehabilitation cannot permanently reverse spinal cord damage, research has shown that spinal cord injury rehabilitation can aid those who have spinal cord injury (SCI) to lead the fullest life possible.

What Is Spinal Cord Injury Rehabilitation?

Following a traumatic spinal cord injury, one might feel that their whole world has changed. Recovering from SCI can be a challenging and long process, even for those who are bold and strong. Rehabilitation of the patient following an SCI is initiated during the acute treatment phase. With the improvement in the condition of the patient, a more extensive rehabilitation program is often initiated. The outcome of rehabilitation depends on various factors, which are as follows:

• Family support.

• The overall health of the patient.

• Severity and level of the SCI.

• Degree and type of resulting disabilities and impairments.

It is essential to maximize the capabilities of the patient both at home and in the community. Positive reinforcement aids recovery by enhancing self-esteem and promoting independence. The aim of SCI rehabilitation is to enable the patient to revert to the highest level of independence and function possible while enhancing the overall quality of life physically, socially, and emotionally. The spinal cord injury rehabilitation team centers around the patient and family and helps set both short- and long-term treatment goals for recovery. The spinal cord injury rehabilitation team encompasses many skilled professionals like neurologists or neurosurgeons, orthopaedists or orthopedic surgeons, social workers, physical therapists, occupational therapists, internists, psychologists or psychiatrists, dietitians, recreational therapists, and so on.

What Are the Various Spinal Cord Injury Treatment Programs?

The following are the various spinal cord injury treatment programs:

• Acute rehabilitation programs.

• Subacute rehabilitation programs.

• Transitional living programs.

• Long-term rehabilitation programs.

• Day-treatment programs.

• Vocational rehabilitation programs.

What Are the Areas That Are Covered in Spinal Cord Injury Rehabilitation Programs?

The following are the areas that are covered:

• Self-care skills, including daily activities like bathing, dressing, feeding, and so on.

• Mobility skills like walking, self-propelling a wheelchair, and support of heart and lung function.

• Respiratory care includes ventilator care (if required), breathing treatments, and exercises to enhance lung function.

• Physical care like skin care, nutritional needs, and support of heart and lung function.

• Communication skills like writing, speech, and alternative methods of communication.

• Vocational training, like work-related skills.

• Socialization skills like interacting with others both at home and in the community.

• Psychological counseling.

• Making the patient’s family understand the individual’s condition and educating them to offer the needed support to the patient to adapt to lifestyle changes, financial concerns, and so on.

• Educating the patient and their family about SCI, adaptive techniques, home care needs, and so on.

• Managing pain and muscle spasticity through medications and alternative methods.

What Are a Few Spinal Cord Injury Rehabilitation Programs?

A few spinal cord injury rehabilitation programs are as follows:

• Physical Therapy Program: A physical therapist is the most important member of the SCI rehabilitation team who will help an individual improve their mobility, regain function, and prevent complications that may crop up years after the initial traumatic injury. A physical therapy program following SCI encompasses strength training, mobility training, cardiovascular exercise, stretching, and respiratory conditioning. Though physical therapists can assist the patient in moving better and easier, barriers like somatic and neuropathic pain, ventilator dependence, and psychosocial challenges can hinder the recovery process.

• Weight-Supported Locomotor Training (WSLT): WSLT has been found to improve mobility and may be a part of an intensive SCI rehabilitation program. WSLT utilizes both therapists and assisted devices to support the weight while walking on the ground or on a treadmill. The aim of WSLT is to enhance the remaining nerve connectivity between areas that are situated above the traumatic injury and the locomotor central pattern generator with the spinal cord. The locomotor central pattern generator is a region comprising neurons that can trigger certain movements without any sensory input or input from the brain. Apart from enhancing assisted mobility, WSLT supports cardiorespiratory health and may prevent joint-related complications and pressure sores in SCI.

• Functional Electrical Stimulation (FES): FES is a part of SCI rehabilitation that has shown huge results, especially in those who have survived a severe spinal cord injury. FES comprises a device that is basically a generator (stimulator) that is connected to electrodes. Both of these parts are surgically implanted near the spinal cord. Pulses of low-electric activity are transmitted down the spine that imitates the brain signals that activate muscular movement. The aim of FES is to activate the nerves that have been affected by the traumatic injury, which may enable one to regain motor control, move the upper body, walk, and have normal bladder and bowel function. Also, FES can minimize the chances of developing certain systemic complications of chronic SCI, like respiratory problems and pressure sores.

• Occupational Therapy: The role of an occupational therapist involves addressing emotional, social, and functional aspects of life following an SCI. The aim of the occupational therapist is to help one obtain as much independence as possible following the injury. Occupational therapy targets incorporating adaptive devices into one’s daily life to support their independence at work and at home. These devices include wheelchairs, spinal braces and orthoses, lifts, bathroom equipment, controls for televisions, phones, or lights, and so on.

• Psychological Support: Recovering from SCI involves not only physical recovery but also mental recovery. One has to endure various emotional and mental hurdles following a SCI. One’s life might seem to go topsy-turvy all of a sudden. Hence, an individual may require help from a recreational therapist or a psychologist to support their overall well-being following a SCI. A psychologist or a recreational therapist may aid the patient and their family by educating them about strategies to cope with leading a life after SCI. Various techniques, like music therapy, talk therapy, and others, may be suggested to deal with anxiety and depression.

Conclusion:

Recovery from a spinal cord injury involves lots of important choices and significant challenges. In such situations, relying on the spinal cord injury rehabilitation team of skilled professionals may seem to be the only option. These experts help one regain their function, improve the existing function, and preserve a good quality of life. Numerous trained professionals, like neurologists, occupational therapists, plastic surgeons, speech-language pathologists, dietitians, urologists, and so on, work together as a team to extend a helping hand to the survivors of SCI.