Spinal Injury Rehabilitation & Treatment

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. The majority of people affected by spinal cord damage are in fact defined as incomplete Spinal Cord Injury (ISCI).

This means that the sensory and movement loss is only partial and so their clinical picture may be much more complex than a complete spinal injury.

Both complete and incomplete spinal cord injury symptoms vary from one person to the next and may include weakness, spasms, altered sensation and bladder and bowel problems.

Complete SCI treatment needs to focus on maximising the ability to compensate for body parts which are paralysed and enable a new functional ability.

Incomplete SCI treatment aims to ensure that spared activity is facilitated and not lost due to compensatory activity in other body parts. A careful assessment determines potential recovery and also evaluates where compensation would be essential.

Sometimes early management in regaining independence may result in people being treated as if they have a complete spinal injury, but at Manchester Neurotherapy Centre we have often found that there may be potential for greater recovery than first expected.

Neurophysiotherapists at MNC use an approach based on the Bobath concept, which has shown particular benefit in treatment of patients with incomplete spinal cord injuries.

We believe 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.

Improving movement and postural efficiency and so reducing compensation sometimes means patients can reduce their antispasmodic drugs.

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.