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  • Print publication year: 2006
  • Online publication date: August 2010

37 - Rehabilitation in spinal cord injury

from Section C - Disease-specific neurorehabilitation systems

Summary

The key to rehabilitation of the patient with acute spinal cord injury (SCI) is a strong team approach. The neurologic level of injury is determined according to the results of the motor and sensory examination. SCI may be complicated by respiratory disorders, venous thrombosis (DVT), and pulmonary embolism (PE), pressure ulcers, autonomic dysreflexia (AD), heterotopic ossification (HO), urinary tract infections (UTIs), renal calculi, gastrointestinal dysfunction, spasticity, and pain. The most accurate predictor for recovery from SCI is the standardized physical examination as endorsed by the International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients(ASIA and IMSOP, 2000), that is, the neurologic (motor) level and severity. SCI with higher ASIA impairment levels have varying degrees of recovery. Research on complete tetraplegia has provided the best predictive data on functional outcomes. Functional outcome-based guidelines provide estimates of the effect of rehabilitation on functional abilities.