Spinal Cord Injury Rehabilitation

Introduction

According to research by the Christopher and Dana Reeve Foundation, nearly 1 in 50 people in America, approximately six million, are living with paralysis today. That is the equivalent of the combined populations of Philadelphia, Los Angeles and Washington, D.C.

Almost a quarter of these six million people is paralyzed as the result of a spinal cord injury. Of these, more than half are caused by either a motor vehicle accident (24 percent) or an accident at work (28 percent). The remainder is caused by a sporting or recreation accident, fall, act of violence, birth defect, or natural disaster.

Long-term consequences of SCI

The spinal cord is part of the central nervous system, responsible for transmitting messages between the brain and the rest of the body to keep us alive, functioning and communicating with one another. Once the spinal cord has been damaged, that is the end of nerve transmission between the brain and that level of the spine where the damage has occurred. Functions below the point of injury will be discontinued, while those above the site of the injury will continue unimpeded. The types of impairment experienced include loss of sensory or motor function, difficulty breathing, and problems with the bowel and bladder.

Neurorehab, who does what

Once the acute phase of the injury has passed, and the individual’s condition is stable, then rehabilitation can take place. It is important that this happens as soon as possible. Up to six months after the injury, some restoration of function is possible. Beyond six months, rehabilitation becomes more difficult and less effective.

Rehabilitation is most effective with a multidisciplinary approach involving:

  • Physiotherapists who focus on the lower extremities and improving mobility.
  • Occupational therapists who concentrate on the upper extremities and restoring the activities of daily living.
  • Rehabilitation nurses to manage pressure sores and problems with bowel and bladder function.
  • Psychologists to deal with the emotional repercussions of a spinal cord injury and any cognitive impairment.
  • Speech and language therapists who work with patients on communication and swallowing.
  • Case managers and social workers who coordinate activities and communication between patients, families, healthcare professionals and payers.

Financial consequence
All those physios, nurses, etc., they have to be fed. There is no teeming pool of qualified, independently wealthy talent able and willing to donate their time, education and experience. The rehabilitation period can require months or even years of inpatient care, the use of highly sophisticated equipment and costly drugs.

Rehabilitation from spinal cord injury cannot guarantee that every patient can expect to restore full function. Many people will require specialist care all their lives. Those with damage to the cervical spinal cord may be completely dependent for all care although some may achieve some degree of independence with the help of assistive devices and may even be able to drive a specially adapted motor vehicle.

Patients with thoracic or lumbar damage may achieve mobility with the aid of wheelchairs and other devices. Insurance may go a long way to cover the expenses of rehabilitative care. Some individuals may have to pursue compensation for their injuries through the courts.

References

Paralysis and Spinal Cord Injury in the United States,” ChristopherReeve.org (accessed Dec. 12, 2014)
Rehabilitation of Persons With Spinal Cord Injuries,” M F Saulino, et al., Medscape (Sept. 10, 2014)
Spinal Cord Injury Rehabilitation,” BrainandSpinalCord.org (accessed Dec. 12, 2014)
Nerve and Spinal Cord Injury,” Neuroscience Research Australia (accessed Dec. 12, 2014)