Occupational Therapy After Spinal Cord Injury (SCI)

Spinal cord injury symptoms and functional outcomes after occupational therapy are unique to each individual. Our goal is to maximize functional independence and mobility during rehabilitation at Gillette. We customize your therapy to you and your family’s needs by working as a team. The following information is meant to provide you with general information on what occupational therapy will address after a spinal cord injury.

The muscles affected by a cervical spinal cord injury include the neck, shoulders, diaphragm, elbows, wrists and fingers. Treatment after a cervical spinal cord injury may include:

• Increasing independence with participating in and directing your cares-transfers, positioning and self-cares (i.e. feeding, dressing, brushing teeth)
• Completing activities of daily living using adapted equipment, as needed (i.e. reacher, adapted eating utensils, sock aide, wash mitt, commode, bath chair)
• Training in orthotics, prosthetics and seating, if needed, in order to learn new ways to communicate and participate in activities that are meaningful to you—this may include using your breath, voice, eye movement, touch, and/or an adapted keyboard, mouse or smartphone
• Maximizing arm and hand function through various strengthening exercises and activities:
  • Orthotics may be used to support the joints of your arms or hands in order to perform tasks and prevent muscle tightness
  • Mobile arm support may be utilized to promote active movement in your upper extremities
  • Stretching may be appropriate to keep your joints healthy
  • Muscle training and re-education through the use of specialized equipment and other modalities, which may include the pool, electrical stimulation and/or virtual reality when applicable
  • Learning how to use your arms to support yourself in sitting positions, to roll in bed and to assist with transfers
• Determining the most functional means of mobility, which could include using a manual and/or power wheelchair and teach you how to move as safely and as independently as possible and in different environments
• Determining what type of equipment and environmental modifications you/your child may need at home and at school to return to productive lives

The muscles affected by a thoracic level spinal injury include the hands, upper chest, abdominal muscles and trunk muscles. Treatment after a thoracic spinal cord injury may include:

• Learning basic activities of daily living: gaining independence with bathing, dressing, and toileting and learning to use adapted equipment as needed (i.e. shower chair, long-handled sponge and reacher)
• Practicing instrumental activities of daily living: learning how to complete household chores and meal preparation with or without assistive devices
• Working on mobility skills including sitting balance, scooting and transferring in and out of a wheelchair onto a variety of surfaces (bed, mat, car); you may also work on sliding board or stand-pivot transfers in OT and PT
• Improving fine motor control skills needed for self-cares (shoe tying), leisure (board games, video games) and communication (handwriting, typing)
• Increasing endurance to propel a manual wheelchair longer distances and on slightly uneven terrain
• Maximizing shoulder, elbow, wrist and hand strength so that you can engage in activities that are meaningful to you
• Education on how to protect your shoulder joints from overuse injury through stretching and strengthening exercises
• Education on energy conservation techniques
• Determining any necessary equipment and environmental modifications at home and at school

The muscles affected by a lumbar level spinal cord injury include the hips and legs. Treatment after a lumbar spinal cord injury may include:

• Learning ways to safely move with/without an assistive device as you complete your self-cares, leisure activities and instrumental activities of daily living (i.e. making a meal, washing dishes)
• Standing endurance and balance skills will be facilitated during a variety of activities
• Stretching and strengthening exercises needed to protect the joints in your upper extremities as you use a wheelchair, walker and/or forearm crutches
• Evaluating the need for specialized equipment and environmental modifications at home and at school