Spinal cord injury rehabilitation includes three phases: acute, inpatient, and outpatient. At each phase, care providers can assess the patient to determine the needs specific to the case and develop an appropriate multidisciplinary therapy program. The level and type of therapy necessary can depend on the injury, the goals of the patient, and the patient's progress in spinal cord injury rehab. Care providers work to increase mobility and independence for patients and also provide education to help people with spinal cord injuries manage them and limit long-term risks associated with such injuries.
In the acute phase immediately after the injury, spinal cord injury rehab can include basic exercises to retain mobility and prevent muscle contractures. Patients often experience pain and fatigue immediately after an injury. A care provider can work with the patient to develop strength and stamina. The team may include physical therapists, pain specialists, and psychologists who can help patients adjust to life after a spinal cord injury.
As the patient leaves the immediate danger zone and appears stable, she can be transferred to inpatient spinal cord injury rehab. Inpatients stay in a hospital or spinal cord rehab center and usually undergo sessions of therapy every day. They typically work with several different therapists. The work can include physical therapy for mobility and strength, vocational therapy to relearn job skills, and occupational therapy to develop fine motor coordination. Some patients need speech-language therapy to help them communicate, and others may benefit from bladder and bowel therapy, where they learn toileting techniques.
Throughout inpatient spinal cord injury rehab, regular patient assessments can measure progress and help therapists determine what kind of therapy sessions would be most appropriate. A patient may not be able to return to work, in which case recreational therapy to develop the strength and coordination for recreational activities might be recommended. Other patients may want to develop work-specific skills. Parents may want to work with a psychologist on childcare skills, and therapists can also meet with patients and their family to discuss accommodations and modifications that may need to be made in the home environment.
Outpatient spinal cord injury rehab allows a patient to go home and return to a care facility for therapy appointments. These may be close together in the beginning. As the patient develops more strength and independence, the appointments can be less frequent. The therapist can assess progress, talk about specific issues, and make the patient aware of any new developments in the treatment and rehabilitation of spinal cord injuries.