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Spinal Cord Injury Rehabilitation
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Chronic Injury Phase Intervention
Maintain functional gains, promote a healthy lifestyle. PT role includes ongoing exercise, adaptive sports, and community reintegration.
C1-C4 Injury Level
Potential for head and neck movement only, ventilator may be required for breathing. PT focuses on respiratory function, assistive technology for ADLs and mobility.
Electrical Stimulation Therapy
Improved muscle strength, prevention of atrophy, potentially some restored function. PT role in determining parameters, electrode placement, and integrating with other treatments.
Robotic-Assisted Gait Training
Allows high-intensity, repetitive movement practice, improves gait, may restore walking function. PT adjusts the device, supervises training, and ensures safety.
Proprioceptive Neuromuscular Facilitation (PNF)
Enhances muscular strength and range of motion, improves motor control. PT applies PNF patterns, adjusts intensity and complexity, educates patients about techniques.
Constraint-Induced Movement Therapy
Expands use of affected limbs, reformats the brain's mapping of movement. PT involves restraint of unaffected limbs and intensive practice of affected ones.
Acute Injury Phase Intervention
Minimize secondary damage, maintain range of motion, prevent pressure sores. PT role is early mobilization, respiratory care, and patient education.
Stretching and Flexibility Training
Prevents muscle shortening, enhances joint range, promotes relaxation. PT monitors stretching techniques, ensures safety, and assesses flexibility.
Functional Electrical Stimulation (FES) Cycling
Promotes cardiovascular health, prevents muscle atrophy, and improves bone density. PT ensures proper setup, progression of resistance, and monitors fatigue.
C7-C8 Injury Level
Elbow extension, finger movement, good upper body strength. PT aims to improve manual dexterity, increase independence in transfers, and work on wheelchair mobility.
Range of Motion Exercises
Prevents contractures, maintains joint health, aids in circulation. PT ensures exercises are done properly, records progress, and adjusts as needed.
T6-T12 Injury Level
Further increased trunk control, better balance. PT emphasizes on developing lower body muscle strength, wheelchair-to-bed transfers, and potentially standing exercises.
Sitting Balance Training
Improves static and dynamic balance, helps prevent falls, increases independence. PT guides progression and offers strategies for balance control.
Body Weight Supported Treadmill Training (BWSTT)
Aids in step training, improves walking patterns, can decrease spasticity. PT monitors progress, adjusts support and challenges the patient.
Gait Training with Assistive Devices
Improves walking ability, ensures safe mobility, can enhance independence. PT selects appropriate devices, trains in their use, and adjusts gaits accordingly.
S1-S5 Injury Level
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.
Strengthening Exercises
Increases muscle power, improves movement efficiency, supports functional activity. PT prescribes exercise regimen, oversees form, and progresses load.
Aquatic Therapy
Enhanced mobility due to buoyancy, reduced pressure on joints, improved muscle symmetry. PT uses water resistance for strength training and pain relief.
Transfer Training
Increases independence, safety in moving between surfaces. PT educates on proper techniques, practices transfers, and assesses the need for assistive devices.
Manual Muscle Testing
Assessment of muscle strength, identification of muscle imbalances, informs treatment planning. PT’s role in grading strength and formulating goals.
C5 Injury Level
Some shoulder and elbow function; no wrist or hand movement. PT targets mobility and strength training for shoulder and elbow, and adaptive equipment training.
C6 Injury Level
Shoulder and elbow control and some wrist extension. PT works on tenodesis grip training, wheelchair skills and transfers.
L1-L5 Injury Level
Partial leg function, potential to walk with assistive devices. PT involves gait training, lower extremity strengthening, and use of orthotic devices.
Standing Frame Use
Enhances bone density, assists bowel function, discourages contractures. PT assists in acclimatizing to the device, monitors tolerance, and encourages routine use.
Neuro-Developmental Treatment
Improves movement patterns, coordination, and promotes normal motor development. PT uses hands-on facilitation and guides task-specific functional activities.
T1-T5 Injury Level
Intact upper body movements, increased trunk stability. PT promotes strengthening of upper body and trunk, wheelchair sports participation.
Subacute Injury Phase Intervention
Improve functional independence, neuromuscular re-education. PT focuses on building strength, cardiopulmonary endurance, and motor skills.
Wheelchair Skills Training
Increases mobility and independence, reduces risk of pressure sores. PT teaches techniques for propulsion, navigating terrain and pressure relief maneuvers.
Balance and Coordination Drills
Enhances stability and agility, reduces fall risk, improves confidence. PT customizes exercises, progresses challenge, and provides feedback.
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