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Spinal Cord Injury Rehabilitation

The spinal cord is very sensitive to injury. Unlike other parts of the body, the spinal cord does not have the ability to repair itself, if damaged. Causes: A spinal cord injury (SCI) occurs when there is damage to the spinal cord from: Trauma Loss of its normal blood supply Compression from tumor or infection

The most common cause of spinal cord injury is trauma. Nearly half of SCI injuries are caused by motor vehicle accidents. Other common types of trauma include falls from heights, violence and sports injury. Symptoms of SCI depend on where the spinal cord is injured and whether or not, the injury is complete or incomplete. Incomplete Injury refers to patients who have some remaining function of their bodies (below the level of injury) Complete Injury refers to patients who have NO function below the level of injury Quadriplegia refers to injury of the upper portion of the spinal cord (in the neck). This may cause paralysis & loss of sensation in both arms and legs. In addition, this injury may contribute to breathing difficulty and loss of control over bowel & bladder function. Paraplegia refers to spinal cord injury of lower areas of the back. This may cause paralysis, sensory loss of both legs in addition to loss of control over bowel and bladder function. Treatment & Rehabilitation Following a spinal cord injury, research has shown that prompt treatment can improve capacity for functional recovery. Early surgical decompression and stabilization may improve chances of recovery. Aggressive physical therapy and rehabilitation after surgery also maximizes recovery potential. The majority of recovery occurs within the first six (6) months following injury. Any remaining loss of function (present) after twelve (12) months is much more likely to become permanent. Rehabilitation and recovery from spinal cord injury depends very much on the type of injury. The primary goals of rehabilitation are: Maximizing physical function Prevention of secondary complications Reintegration into the community

Complications Spinal cord injury (SCI) can affect the body in many different ways: Respiration Lead to pneumonia Low blood pressure Irregular heartbeat Blood clots Spasticity Contractures Autonomic dysreflexia Pressure sores Infections Chronic pain Bladder and bowel problems Reproductive and sexual function issues Depression and anxiety issues

Rehabilitation following spinal cord injury (SCI) is most effective when undertaken with the support of a multidisciplinary team-based approach; under the supervision of a physiatrist or physician (specialized in spinal cord medicine). With respect to spinal cord injury (SCI), each team member has primary responsibilities. Working cohesively, a properly functioning interdisciplinary team can address a variety of complications. For example: Physiotherapy exercise programs typically focus on muscle strengthening and difficulty with mobility. Occupational therapy may help to redevelop motor skills and difficulty with activities of daily living. More specifically, bladder and bowel management programs may teach basic toileting routines. This would be in addition to patients relearning self- grooming techniques. However, for some, mobility will only be possible with the assistance of devices such as a walker, leg braces or a wheelchair.

Rehabilitation nurses may address issues concerning bowel and bladder dysfunction further to management of pressure ulcers and other complications. Speech-Language pathologists address issues of communication and swallowing. Psychologists deal with the emotional and behavioral concerns of newly injured patients with potential cognitive dysfunction.

Social workers are the primary interface between the rehabilitation team, the patient, his/her family in addition to the payment sponsor. Vocational rehabilitation and recreation therapy encourages patients to build on their current abilities. The aim is to try and attain participation in the workplace in addition to recreational or athletic activities (based on level of mobility). Engaging in recreational outlets and athletics may help these patients achieve a more balanced and normal lifestyle. This also provides opportunities for social activity, interaction and self-expression.

Research has shown that spinal cord injuries occur predominantly in people aged below 30 years. The human cost is high. Major improvements in emergency and acute care have improved survival rates. However, this has also led to an increase in the number of individuals who must cope with severe disabilities for the rest of their lives. This burden of life for both patients (i.e. lost income) & society (in terms of health care cost related to disability) is extremely high in comparison to other medical conditions. There is currently no cure for spinal cord injury at this time. Many physicians and scientists devote their entire professional lives to research targeting potential breakthroughs. While there have been many promising advancements, we hope this will lead to future cure.