Spinal Cord Injury

Physiotherapy plays a crucial role in the rehabilitation and management of spinal cord injury (SCI). Treatment strategies depend on the level and completeness of the injury (complete vs. incomplete), but the overall goals are to:

  • Maximize independence

  • Prevent complications

  • Improve mobility and function

  • Enhance quality of life

1. Rehabilitation

Focus: Strengthening, mobility training, and functional independence

  • Strengthening exercises: For muscles that remain innervated (especially in incomplete SCI), with special attention to upper body strength if wheelchair use is needed.

  • Balance and coordination training: Vital for sitting and standing (if possible), and for transfers.

  • Mobility training: Depending on the injury:

    • Wheelchair training for complete injuries

    • Gait training with assistive devices (e.g., walkers, crutches, KAFOs) for incomplete injuries

  • Functional electrical stimulation (FES): Used to stimulate muscles and improve function (e.g., walking, hand grasp).

  • Hydrotherapy (aquatic physiotherapy): Takes advantage of buoyancy to help with movement and reduce joint strain.

  • Transfer training: From bed to wheelchair, wheelchair to toilet, etc.

2. Long-Term Maintenance

Focus: Prevent secondary complications and promote lifelong fitness

  • Cardiovascular fitness: Adaptive exercises (e.g., arm ergometry) to maintain cardiovascular health.

  • Spasticity management: Stretching, splinting, and positioning; sometimes in collaboration with medication or botox injections.

  • Home exercise programs: To maintain strength and flexibility.

  • Education: Teaching patients and caregivers about skin care, posture, assistive equipment, and long-term health maintenance.