Rehabilitation

What is Rehabilitation

Rehabilitation is a treatment or treatments designed to facilitate the process of recovery from injury, illness, or disease to as normal a condition as possible.

Physical rehabilitation is the process of restoring and regaining physical strength and function. Physical rehabilitation can be used to help treat a simple ankle sprain or to help a stroke survivor walk, talk and eat again.

Physical medicine and rehabilitation physicians, nurses and physical, occupational, speech and recreation therapists work as a team to help patients reduce their dependency on others and achieve the highest level of functional independence.

Spinal Cord Injury Rehabilitation

Treatment for spinal cord injuries can be divided into to two stages: acute and rehabilitation. The acute phase begins at the time of injury, and lasts until the person is stabilized. The rehabilitation phase begins as soon as the person has stabilized and is ready to begin working toward his or her independence.

The Acute Phase

During the acute phase, it is very important that the person receive prompt medical care. The faster the person accesses treatment, the better his or her chances are at having the least amount of impairment possible. In most cases, like in the all too common suv rollover, the injured person will be sent to the closest hospital or center equipped to deal with spinal cord injuries.

The first few days of the acute stage are accompanied by spinal shock, in which the person’s reflexes don’t work. During this stage, it’s very difficult to determine an exact prognosis, as some function beyond what is currently being seen may occur later. At this stage other complications from the accident or injury will also be present, such as brain injury, broken bones, or bruising.

The Rehabilitation Phase

Once the acute phase is over and the person has been stabilized, he or she enters the rehabilitation stage of treatment. Treatment during this phase has the goal of returning as much function as possible to the person. Because all spinal cord injuries are different, a unique plan designed to help the person function and succeed in everyday life is designed. The plan often includes:

  • Helping the person understand his or her injuries
  • Helping the person understand the details regarding his or her care
  • Helping the person become as independent as possible in everyday activities such as bathing, eating, dressing, grooming, and wheelchair use
  • Helping the person learn to accept a new lifestyle, especially pertaining to sexual, recreational, and housing options
  • Helping the person learn how to instruct caregivers in how to assist them
  • Preparing them for vocational rehabilitation
  • In most cases, rehabilitation occurs at an approved and accredited spinal cord injury treatment center.
  • Specific Level of Spinal Cord Injury and Rehabilitation Potential
  • C2 or C3:  Patient is completely dependent for all care
  • C4:  Dependent for all care and usually needs a ventilator
  • C5:  Patient may be able to feed themself using assistive devices, usually needs a type of respiratory support but may be able to break without a ventilator
  • C6:  Patient may be able to push themself on wheelchair indoors and may be able to perform daily living tasks such as eating, grooming, and dressing.
  • C7:  Patient May be able to drive a car with special adaptations or can propel a wheelchair outside
  • C8:  Same as C7
  • T1-T6:  Patient may be able to become independent with self-care and use of a wheelchair
  • T6-T12:  Patient may improve sitting balance and be able to participate in atheltic activities with the use of a wheelchair
  • L1-L5:  Patient may be able to walk short distances with assistive devices.

 

Physical therapy

Physical therapy helps the patient restore the use of muscles, bones, and the nervous system through the use of heat, cold, massage, whirlpool baths, ultrasound, exercise, and other techniques. It seeks to relieve pain, improve strength and mobility, and train the patient to perform important everyday tasks. Physical therapy may be prescribed to rehabilitate a patient after amputations, arthritis, burns, cancer, cardiac disease, cervical and lumbar dysfunction, neurological problems, orthopedic injuries, pulmonary disease, spinal cord injuries, stroke, traumatic brain injuries, and other injuries/illnesses. The duration of the physical therapy program varies depending on the injury/illness being treated and the patient’s response to therapy.

Exercise is the most widely used and best known type of physical therapy. Depending on the patient’s condition, exercises may be performed by the patient alone or with the therapist’s help, or with the therapist moving the patient’s limbs. Exercise equipment for physical therapy could include an exercise table or mat, a stationary bicycle, walking aids, a wheelchair, practice stairs, parallel bars, and pulleys and weights.

Heat treatment, applied with hot-water compresses, infrared lamps, short-wave radiation, high frequency electrical current, ultrasound, paraffin wax, or warm baths, is used to stimulate the patient’s circulation, relax muscles, and relieve pain. Cold treatment is applied with ice packs or cold-water soaking. Soaking in a whirlpool can ease muscle spasm pain and help strengthen movements. Massage aids circulation, helps the patient relax, relieves pain and muscle spasms, and reduces swelling. Very low strength electrical currents applied through the skin stimulate muscles and make them contract, helping paralyzed or weakened muscles respond again.

Occupational therapy

Occupational therapy helps the patient regain the ability to do normal everyday tasks. This may be achieved by restoring old skills or teaching the patient new skills to adjust to disabilities through adaptive equipment, orthotics, and modification of the patient’s home environment. Occupational therapy may be prescribed to rehabilitate a patient after amputation, arthritis, cancer, cardiac disease, head injuries, neurological injuries, orthopedic injuries, pulmonary disease, spinal cord disease, stroke, and other injuries/illnesses. The duration of the occupational therapy program varies depending on the injury/illness being treated and the patient’s response to therapy.

Occupational therapy includes learning how to use devices to assist in walking (artificial limbs, canes, crutches, walkers), getting around without walking (wheelchairs or motorized scooters), or moving from one spot to another (boards, lifts, and bars). The therapist will visit the patient’s home and analyze what the patient can and cannot do. Suggestions on modifications to the home, such as rearranging furniture or adding a wheelchair ramp, will be made. Health aids to bathing and grooming could also be recommended.

Speech therapy

Speech therapy helps the patient correct speech disorders or restore speech. Speech therapy may be prescribed to rehabilitate a patient after a brain injury, cancer, neuromuscular diseases, stroke, and other injuries/illnesses. The duration of the speech therapy program varies depending on the injury/illness being treated and the patient’s response to therapy.

Performed by a speech pathologist, speech therapy involves regular meetings with the therapist in an individual or group setting and home exercises. To strengthen muscles, the patient might be asked to say words, smile, close his mouth, or stick out his tongue. Picture cards may be used to help the patient remember everyday objects and increase his vocabulary. The patient might use picture boards of everyday activities or objects to communicate with others. Workbooks might be used to help the patient recall the names of objects and practice reading, writing, and listening. Computer programs are available to help sharpen speech, reading, recall, and listening skills.