Spinal Cord Injury: Understanding the Spectrum
SCI ranges from incomplete injuries with preserved function to complete injuries with total motor and sensory loss. The American Spinal Injury Association (ASIA) Impairment Scale classifies injury severity and guides prognosis.
Acute Rehabilitation Priorities
Respiratory physiotherapy (for high thoracic and cervical injuries), pressure injury prevention through positioning and turning, passive range of motion for all joints, wheelchair skills training, and spasticity management.
Locomotor Training
Body-weight supported treadmill training (BWSTT) provides repetitive stepping to activate spinal cord locomotor circuits. Functional Electrical Stimulation (FES) cycling activates paralyzed muscles, maintaining cardiovascular fitness and muscle mass.
Upper Limb Function in Tetraplegia
For cervical injuries, upper limb rehabilitation is critical for independence. Tenodesis grasp training, wrist extensor strengthening, and assistive technology maximize functional independence.
Long-Term Rehabilitation Goals
Community mobility, pressure injury prevention education, bowel and bladder management, sexual health, pain management, and cardiovascular fitness are the long-term rehabilitation focus areas.