The following chart is a comparison of the specific level of SCI and the resulting rehabilitation potential. This chart is a guide, with general information only; impairments and rehabilitation potential can vary depending on the type and severity of SCI. Always consult your physician for more specific information based on your individual medical condition and injury.
|
Level of injury
|
Possible impairment
|
Rehabilitation potential
|
|
C2 - C3
|
Usually fatal as a result of inability to breathe
|
Totally dependent for all care
|
|
C4
|
Quadriplegia and breathing difficulty
|
Dependent for all cares; usually needs a ventilator
|
|
C-5
|
Quadriplegia with some shoulder and elbow function
|
May be able to feed self using assistive devices; usually can breathe without a ventilator, but may need other types of respiratory support
|
|
C6
|
Quadriplegia with shoulder, elbow, and some wrist function
|
May be able to propel a wheelchair inside on smooth surfaces; may be able to help feed, groom, and dress self; dependent on others for transfers
|
|
C7
|
Quadriplegia with shoulder, elbow, wrist, and some hand function
|
May be able to propel a wheelchair outside, transfer self, and drive a car with special adaptions; may be able to help with bowel and bladder programs
|
|
C8
|
Quadriplegia with normal arm function; hand weakness
|
May be able to propel a wheelchair outside, transfer self, and drive a car with special adaptions; may be able to help with bowel and bladder programs
|
|
T1 - T6
|
Paraplegia with loss of function below mid-chest; full control of arms
|
Independent with self care and in wheelchair; able to be employed full time
|
|
T6 - T12
|
Paraplegia with loss of function below the waist; good control of torso
|
Good sitting balance; greater ability for operation of a wheelchair and athletic activities
|
|
L1 - L5
|
Paraplegia with varying degrees of muscle involvement in the legs
|
May be able to walk short distances with braces and assistive devices
|
Spinal Cord Injury Rehabilitation
Rehabilitation of the patient with a SCI begins during the acute treatment phase. As the patient's condition improves, a more extensive rehabilitation program is often begun.
The success of rehabilitation depends on many variables, including the following:
- level and severity of the SCI
- type and degree of resulting impairments and disabilities
- overall health of the patient
- family support
It is important to focus on maximizing the patient's capabilities at home and in the community. Positive reinforcement helps recovery by improving self-esteem and promoting independence.
The goal of SCI rehabilitation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life - physically, emotionally, and socially.
Areas covered in spinal cord injury rehabilitation programs may include:
|
Patient need:
|
Example:
|
|
Self-care skills, including activities of daily living (ADLs)
|
Feeding, grooming, bathing, dressing, toileting, and sexual functioning
|
|
Physical care
|
Support of heart and lung function, nutritional needs, and skin care
|
|
Mobility skills
|
Walking, transfers, and self-propelling a wheelchair
|
|
Respiratory care
|
Ventilator care, if needed; breathing treatments and exercises to promote lung function
|
|
Communication skills
|
Speech, writing, and alternative methods of communication
|
|
Socialization skills
|
Interacting with others at home and within the community
|
|
Vocational training
|
Work-related skills
|
|
Pain and muscle spasticity (increased muscle tone) management
|
Medications and alternative methods of managing pain and spasticity
|
|
Psychological counseling
|
Identifying problems and solutions for thinking, behavioral, and emotional issues
|
|
Family support
|
Assistance with adapting to lifestyle changes, financial concerns, and discharge planning
|
|
Education
|
Patient and family education and training about SCI, home care needs, and adaptive techniques
|
The spinal cord injury rehabilitation team revolves around the patient and family and helps set short-and long-term treatment goals for recovery. Many skilled professionals are part of the spinal cord injury rehabilitation team, including any/all of the following:
- neurologist/neurosurgeon
- orthopaedist/orthopaedic surgeon
- physiatrist
- internists
- rehabilitation nurse
- social worker
- physical therapist
- occupational therapist
- speech/language pathologist
- psychologist/psychiatrist
- recreation therapist
- dietitian
- vocational counselor
- orthotist
- case manager
- respiratory therapist
- chaplain
There are a variety of spinal cord injury treatment programs, including the following:
- acute rehabilitation programs
- subacute rehabilitation programs
- long-term rehabilitation programs
- transitional living programs
- day-treatment programs
- vocational rehabilitation programs