ADULT REHABILITATION · Health guide
Rehabilitation After Spinal Cord Injury
Movement, transfers and independent-living skills after spinal cord injury: skin protection, assistive devices and regular follow-up.
Updated: · General information
What is it, how common is it and how does it occur?
Spinal cord injury is damage, from trauma or other causes, to the nerve tissue within the spinal column (medulla spinalis); by affecting nerve conduction between the brain and the limbs, it can cause loss of sensation and partial or complete paralysis. It is more common in young men. The principal causes include road traffic collisions (36–48%), violence (5–29%), falls (17–21%) and sport or recreational activities (7–16%); according to data from Türkiye for the year 2000, the leading causes were road traffic collisions (48.8%), falls (36.5%) and injuries from sharp or penetrating instruments (3.3%). Damage in the thoracic or lumbar region can cause weakness in both legs (paraplegia), and damage in the cervical region weakness in the arms and legs (tetraplegia).
Management in the acute phase
The aim at the first stage is to prevent secondary nerve damage and complications; surgical stabilisation or spinal orthoses may be used. Once medical or surgical stabilisation has been achieved, early rehabilitation is of critical importance in preventing complications and supporting functional independence.
Rehabilitation goals and the team
The rehabilitation team comprises a specialist in physical medicine and rehabilitation, a physiotherapist, a nurse, a psychologist, a social worker and an orthotics and prosthetics technician; the central aim is to support independent living and social and occupational reintegration. The principal interventions include correct positioning to prevent joint contractures and pressure sores, bladder and bowel management, management of spasticity with medication and, where needed, botulinum toxin, prevention of deep vein thrombosis, training in sitting and standing balance and in transfers, gait training with assistive devices, virtual reality and robotic gait systems, and training in activities of daily living (dressing, wheelchair use).
Why does the level of injury matter?
The level of damage in the spinal cord, and whether it is complete or incomplete, affects movement of the limbs and sensory function. Rehabilitation assessment does not focus on walking alone; sitting balance, transfers, breathing and daily self-care are also addressed. Bladder and bowel management is planned together with the relevant teams.
Developing daily independence
Choosing a wheelchair, access within the home, pressure relief and training in skin checks can all be important parts of the programme. In areas where sensation is lost, a wound may go unnoticed. The amount of assistance required and the need for equipment are reviewed regularly; goals are set together with the person’s living circumstances and preferences.
Your questions
Patient information
Is walking again the only aim of rehabilitation?
No. Safe transfers, self-care and social participation are also core goals. The likelihood of walking is assessed according to the characteristics of the injury.
Is follow-up needed after discharge?
Yes. The skin, the joints, the fit of equipment and daily-living needs can all change over time. It should be agreed in advance which team to contact if new problems arise.
