Physical Therapy After Spinal Cord Injury (SCI)

Spinal cord injury symptoms and functional outcomes after physical 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. You can anticipate attending physical therapy 6 days per week in inpatient rehabilitation. The following information is meant to provide you with general information on what physical therapy will address after a spinal cord injury.

Some areas we work on in physical therapy include transfers, mat/bed mobility, standing, FES (Functional Electrical Stimulation), wheelchair mobility (for example: propelling, curb navigation and stairs), pool therapy, gait training and more.

The muscles affected by a cervical spinal cord injury can include the muscles of the neck and everything below. Treatment after a cervical spinal cord injury may include:

• Increasing independence with participating in and directing your cares-transfers, positioning and self-cares
• Teaching you how to complete activities of daily living using adapted equipment, as needed (i.e. leg loops, transfer boards/slings, wheelchairs, standers)
• Maximizing neck, shoulder and arm function through various strengthening exercises and activities:
  • Orthotics may be used to support the joints of your knees and ankles in order to perform tasks and prevent muscle tightness
  • 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, 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
• Helping you determine 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 spinal injury can include the hands, upper chest, abdominal muscles, trunk muscles and legs. Treatment after a thoracic spinal cord injury may include:

• Working on mobility skills including sitting balance, scooting and transferring in and out of a wheelchair onto a variety of surfaces (bed, mat, floor, and car); you may also work on sliding board or stand-pivot transfers in OT and PT
• Determining if orthotics may be used to support and protect your knees and ankles during standing and everyday activities
• Increasing endurance to propel a manual wheelchair longer distances and on slightly uneven terrain
• Maximizing shoulder, elbow, wrist and trunk 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 can include the hips and legs. Treatment after a lumbar spinal cord injury:

• Working on mobility skills including sitting balance, scooting and transferring in and out of a wheelchair onto a variety of surfaces (bed, mat, floor, and car); you may also work on sliding board or stand-pivot transfers in OT and PT
• Determining if orthotics may be used to support and protect your knee and ankle joints during standing and other everyday activities
• Gait training as appropriate with or without assistive devices such as a walker, or crutches as well as robotic-assisted locomotor training (Lokomat®), advanced technology such as the ReWalk exoskeletal system as indicated
• Increasing endurance to propel a manual wheelchair longer distances and on slightly uneven terrain
• You will work on maximizing shoulder, elbow, wrist and trunk strength so that you can engage in activities that are meaningful to you
• Education on energy conservation techniques
• Standing endurance and balance skills will be facilitated during a variety of activities
• Teach stretching and strengthening exercises needed to protect the joints in your upper extremities as you use a wheelchair, walker and/or forearm crutches
• Evaluate the need for specialized equipment and environmental modifications at home and at school