Spinal Injury Rehabilitation & Treatment
Spinal Cord Injury
Although people often associate Spinal Cord Injury (SCI) with total paralysis and wheelchair use for life, many patients will have damage that is not complete but have some sparing of motor and or sensory function. Incomplete Spinal Cord Injury (ISCI) means that the sensory and movement loss is only partial and so their clinical picture may be more complex than a complete spinal injury. Therefore spinal cord injury treatment and spinal injury rehabilitation can offer considerable benefits for individuals with spinal cord injuries.
Incomplete spinal cord injury symptoms vary from one person to the next and may include weakness, spasms, altered sensation and bladder and bowel problems. Sometimes early management in regaining independence may mean they are then treated as if they have a complete spinal injury, but we have found that there may be potential for greater recovery than first expected. Neuro-Physiotherapists here at Manchester Neurotherapy Centre use the Bobath concept, which has particular benefit in treatment of patients with incomplete spinal cord injuries.
We believe it is important that the person is encouraged to explore their own movement and understand how they can control and influence it to improve their ability to function from day to day. Each spinal injury case presents slightly differently, both due to the level of the lesion in the spinal cord and also due to the severity of damage at that level and whether or not the damage involves more than one level of the spinal cord. Therefore it is vital that in spinal injury therapy each person is assessed individually to ascertain how much potential for recovery there is available. This will involve an assessment of the deficits due to the lesion but also the strategies that have developed in order to function in their daily life. These are called compensatory strategies and can mask improvement and make some aspects worse for example spasms and limb weakness. We often find that patients can reduce their antispasmodic drugs through exploring different movement options and postures.
In spinal cord therapy, initially an assessment will be carried out which involves identifying current functional abilities and those goals that the person would like to achieve. An assessment of the person’s potential is begun by exploring their balance and postural control and assessing the ability of the body to respond to movement and displacement. How much sensation the person has to touch or movement is also important to assess. Often certain parts of the body will become particularly stiff and moving these can make other movements easier, for example, mobilising the ribcage to improve the movement of the arm and increase lung capacity and in turn, fitness.
Whether someone is walking independently, using walking aids or in a wheelchair it is important to analyse how they move. The analysis of how someone reaches whilst in a wheelchair or how someone moves in bed or takes a step are all examples of activities we would assess. The aim of therapy is to make life easier for the person with an incomplete spinal cord injury, to reveal and exploit any hidden potential, to improve function and to develop a programme which can be followed independent of the physiotherapy as well as generally give help and advice.