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Spinal Cord Injury Rehabilitation

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Chronic Injury Phase Intervention

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Maintain functional gains, promote a healthy lifestyle. PT role includes ongoing exercise, adaptive sports, and community reintegration.

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C1-C4 Injury Level

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Potential for head and neck movement only, ventilator may be required for breathing. PT focuses on respiratory function, assistive technology for ADLs and mobility.

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Electrical Stimulation Therapy

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Improved muscle strength, prevention of atrophy, potentially some restored function. PT role in determining parameters, electrode placement, and integrating with other treatments.

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Robotic-Assisted Gait Training

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Allows high-intensity, repetitive movement practice, improves gait, may restore walking function. PT adjusts the device, supervises training, and ensures safety.

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Proprioceptive Neuromuscular Facilitation (PNF)

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Enhances muscular strength and range of motion, improves motor control. PT applies PNF patterns, adjusts intensity and complexity, educates patients about techniques.

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Constraint-Induced Movement Therapy

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Expands use of affected limbs, reformats the brain's mapping of movement. PT involves restraint of unaffected limbs and intensive practice of affected ones.

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Acute Injury Phase Intervention

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Minimize secondary damage, maintain range of motion, prevent pressure sores. PT role is early mobilization, respiratory care, and patient education.

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Stretching and Flexibility Training

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Prevents muscle shortening, enhances joint range, promotes relaxation. PT monitors stretching techniques, ensures safety, and assesses flexibility.

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Functional Electrical Stimulation (FES) Cycling

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Promotes cardiovascular health, prevents muscle atrophy, and improves bone density. PT ensures proper setup, progression of resistance, and monitors fatigue.

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C7-C8 Injury Level

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Elbow extension, finger movement, good upper body strength. PT aims to improve manual dexterity, increase independence in transfers, and work on wheelchair mobility.

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Range of Motion Exercises

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Prevents contractures, maintains joint health, aids in circulation. PT ensures exercises are done properly, records progress, and adjusts as needed.

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T6-T12 Injury Level

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Further increased trunk control, better balance. PT emphasizes on developing lower body muscle strength, wheelchair-to-bed transfers, and potentially standing exercises.

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Sitting Balance Training

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Improves static and dynamic balance, helps prevent falls, increases independence. PT guides progression and offers strategies for balance control.

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Body Weight Supported Treadmill Training (BWSTT)

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Aids in step training, improves walking patterns, can decrease spasticity. PT monitors progress, adjusts support and challenges the patient.

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Gait Training with Assistive Devices

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Improves walking ability, ensures safe mobility, can enhance independence. PT selects appropriate devices, trains in their use, and adjusts gaits accordingly.

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S1-S5 Injury Level

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Most leg muscles functioning, bladder and bowel movements might be impaired. PT focuses on further improving walking skills, addressing continence, and advising on lifestyle adaptations.

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Strengthening Exercises

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Increases muscle power, improves movement efficiency, supports functional activity. PT prescribes exercise regimen, oversees form, and progresses load.

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Aquatic Therapy

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Enhanced mobility due to buoyancy, reduced pressure on joints, improved muscle symmetry. PT uses water resistance for strength training and pain relief.

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Transfer Training

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Increases independence, safety in moving between surfaces. PT educates on proper techniques, practices transfers, and assesses the need for assistive devices.

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Manual Muscle Testing

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Assessment of muscle strength, identification of muscle imbalances, informs treatment planning. PT’s role in grading strength and formulating goals.

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C5 Injury Level

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Some shoulder and elbow function; no wrist or hand movement. PT targets mobility and strength training for shoulder and elbow, and adaptive equipment training.

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C6 Injury Level

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Shoulder and elbow control and some wrist extension. PT works on tenodesis grip training, wheelchair skills and transfers.

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L1-L5 Injury Level

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Partial leg function, potential to walk with assistive devices. PT involves gait training, lower extremity strengthening, and use of orthotic devices.

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Standing Frame Use

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Enhances bone density, assists bowel function, discourages contractures. PT assists in acclimatizing to the device, monitors tolerance, and encourages routine use.

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Neuro-Developmental Treatment

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Improves movement patterns, coordination, and promotes normal motor development. PT uses hands-on facilitation and guides task-specific functional activities.

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T1-T5 Injury Level

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Intact upper body movements, increased trunk stability. PT promotes strengthening of upper body and trunk, wheelchair sports participation.

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Subacute Injury Phase Intervention

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Improve functional independence, neuromuscular re-education. PT focuses on building strength, cardiopulmonary endurance, and motor skills.

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Wheelchair Skills Training

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Increases mobility and independence, reduces risk of pressure sores. PT teaches techniques for propulsion, navigating terrain and pressure relief maneuvers.

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Balance and Coordination Drills

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Enhances stability and agility, reduces fall risk, improves confidence. PT customizes exercises, progresses challenge, and provides feedback.

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