The Science Zone: The Impact of Intensive Rehabilitation on Spinal Cord Injuries

The latest blog in our Science Zone series has been written by our Founder and Co-Director, Jennifer Wynne in recognition of World Spinal Cord Injury Awareness Day. 

Introduced by The International Spinal Cord Society (ISCoS), the annual event aims to raise awareness of the challenges that people with spinal cord injuries face and to promote a more accessible world. The theme for this year is ‘Access to SCI services – A life less complicated’.

In this blog, Jennifer explores the subject of spinal cord injuries and the impact that intensive rehabilitation can have on our patients’ mobility and quality of life…

 

More people than ever before are living with physical deficits following spinal cord injuries (SCIs). There are an estimated 50,000 people in the UK currently living with an SCI, with 2,500 new cases per year. Only 1/3 of people access specialist NHS treatment following an SCI in the UK. Those who do access specialist NHS centres often experience delays prior to admission and shortened stays/after care. (Source: National Institute for Health and Care Excellence (NICE) guidelines, 2022).

Spinal cord injuries can have a profound impact on a person’s life. The consequences may include paralysis, loss of sensation, difficulties with bodily functions (such as bladder and bowel control), respiratory problems, muscle spasms, chronic pain, and changes in sexual function and fertility. The extent of these effects depends on the severity and level of the injury.

What is an SCI

A spinal cord injury (SCI) refers to damage or trauma to the spinal cord, which is a bundle of nerves that extends from the base of the brain down the back. The spinal cord plays a crucial role in transmitting signals between the brain and the rest of the body. It carries sensory information from the body to the brain and relays motor commands from the brain to the muscles.

Spinal cord injuries can occur due to various causes, including accidents, falls, sports injuries, acts of violence, and diseases such as tumours or infections. The severity of an SCI can vary widely depending on the location and extent of the damage.  The general rule is, the higher up the spinal cord the damage occurs, the more movement and feeling will be lost.

Spinal cord injuries are classified as complete or incomplete:

  • Complete SCI – In this type of injury, there is a total loss of sensory and motor function below the level of injury. It means that there is no feeling or voluntary movement below the affected area.
  • Incomplete SCI- In an incomplete injury, there is some remaining function below the level of injury. The degree of impairment can vary, and individuals may retain partial sensation or movement.

 

Treatment for SCIs

Treatment and management of spinal cord injuries involves a multidisciplinary approach, including medical interventions, rehabilitation programs, assistive devices, and adaptive strategies. Advances in medical research and technology continue to explore potential treatments, such as nerve regeneration and neural prosthetics, to improve the outcomes and quality of life for individuals with spinal cord injuries.

NICE recognises that muscle physiology and neural adaptations can occur after SCI, given time and rehabilitation. We know that the evidence supports that intensive rehabilitation improves gait and strength in those with AIS C and D lesions, up to 3 years after injury (Jones et al, 2014).

Intensive Rehabilitation

As we’ve already mentioned, an SCI will affect different people to varying degrees and the extent of the spinal cord damage will dictate how much rehabilitation can be achieved. In many cases it can take around two years for a patient to reach their full potential for movement and recover after an SCI.  However, the two year window, within which you can make progress, is not a strict rule and certainly only applies if you have had access to the best rehabilitation treatment, plus the opportunity for self-practice over this time. If you have not yet had the chance to receive the best therapy, it is likely you will not have explored your true potential, regardless of how much time has passed post-injury.  Our experience shows us that patients often have greater potential for recovery than expected, if they have access to appropriate expertise and technology.

The Rehab Physio’s team has extensive experience of spinal cord rehabilitation techniques to optimise our patients’ recovery potential, many of which are not available from the NHS. We can offer a range of treatments and technology and develop a rehabilitation plan, tailored to the patient’s exact requirements, condition and stage in their recovery journey.

As with many neurological conditions, at least 80 hours of intensive rehabilitation provides the best outcomes, ie. thousands of repetitions per hour over hundreds of hours. Treatment at this level enables physiological changes to occur, including the generation of new brain cells and nerve pathways, known as neuroplasticity.

This is only possible with the help of technology and our range of robotics and virtual reality technology.  Robotics allow patients to increase the volume of practice, increase the quality of therapy, experience more sustainable improvements and ultimately achieve better treatment outcomes.

Using this intensive approach, complemented by specialist physiotherapy and access to a dedicated rehab gym, SCI patients often see greater improvements in their condition over a shorter space of time.

Steve’s Story

Steve was a full-time wheelchair user when he approached The Rehab Physio following a spinal cord injury.   He was told he would never walk again but following our intensive rehabilitation program, he has hope for the future. Read Steve’s story to find out how we helped him to change his life..

To find out more about our tailored intensive rehabilitation programs, including residential packages, visit the dedicated area of our website.