Spinal Cord Injury Rehabilitation

Understanding Spinal Cord Injury

Damage to the spinal cord that affects movement, sensation, and bodily functions below the level of injury

Complete SCI

No motor or sensory function below the level of injury

Total loss of movement below injury level
No feeling or sensation below injury
Classified as ASIA A on assessment scale
Rehabilitation focuses on compensation and adaptation
Technology and equipment maximize independence

Incomplete SCI

Some motor or sensory function preserved below injury level

Variable amount of movement remains
Some sensation may be present
Classified as ASIA B, C, or D
Greater potential for functional recovery
Intensive therapy can improve outcomes

Levels of Spinal Cord Injury

Function depends on where the spinal cord was damaged

Tetraplegia (Quadriplegia)

Injury Level: Cervical spine (C1-C8)

Affects: Arms, hands, trunk, legs, and pelvic organs

C1-C4 (High Tetraplegia):

Requires ventilator support (C1-C3)
Little to no arm/hand function
Power wheelchair with head/chin controls
Requires full-time attendant care

C5-C8 (Low Tetraplegia):

Some arm/hand function preserved
Can self-propel manual wheelchair (C7-C8)
Can perform some self-care with adaptive equipment
May achieve some independence

Paraplegia

Injury Level: Thoracic, lumbar, or sacral spine (T1-S5)

Affects: Trunk, legs, and pelvic organs (arms unaffected)

T1-T6 (High Paraplegia):

Normal arm and hand function
Poor trunk stability
Can use manual wheelchair independently
Can perform most self-care activities

T7-L5 (Low Paraplegia):

Good trunk control
Can transfer independently
May walk short distances with braces (low levels)
High level of independence achievable

Managing SCI Complications

Pressure Injuries

Skin breakdown prevention through repositioning, cushioning, and skin checks

Bladder/Bowel Management

Catheterization programs, bowel routines, and continence strategies

Spasticity

Medications, stretching, positioning to manage muscle stiffness and spasms

Autonomic Dysreflexia

Recognition and emergency management of dangerous blood pressure spikes

Comprehensive SCI Rehabilitation Program

Mobility Training

Wheelchair skills (manual and power)
Transfer training (bed, car, toilet, shower)
Mat mobility and floor transfers
Standing frame training (if appropriate)
Gait training with orthotics (incomplete SCI)
Community mobility practice

Self-Care Skills

Dressing techniques (upper/lower body)
Bathing and grooming adaptations
Eating and drinking independence
Bowel and bladder management
Medication self-administration
Skin inspection routines

Home Preparation

Home assessment and modifications
Accessible bathroom design
Kitchen adaptations
Bedroom setup and equipment
Ramp and doorway requirements
Family/caregiver training

Equipment & Technology

Wheelchair prescription and setup
Pressure relief cushions
Adaptive devices for daily living
Environmental control systems
Hand splints and orthotics
Computer access modifications

Realistic Goals by Injury Level

Injury Level	Wheelchair	Transfers	Self-Care	Expected Independence
C1-C4	Power (sip-puff/chin control)	Dependent (lift)	Dependent	Requires 24hr attendant
C5-C6	Power or manual	Sliding board with assist	Some with devices	Needs attendant for ADLs
C7-C8	Manual (independent)	Independent	Modified independent	Can live independently
T1-T9	Manual (full independence)	Independent	Independent	Full independence
T10-L2	Manual + possible standing	Independent	Independent	Full independence + limited walking

Emotional & Psychological Support

Adjusting to SCI is a significant life change. Our team provides comprehensive support:

Counseling

Individual and family counseling to process emotions and adapt

Peer Support

Connection with others living successfully with SCI

Education

Understanding SCI, rights, resources, and community reintegration