Spinal cord injury (SCI) is one of the most life-altering injuries a person can experience. In the UK, approximately 2,500 people sustain a new SCI each year. Whether an injury is complete or incomplete, physiotherapy plays a central role in maximising what is possible.

Complete vs Incomplete Injury

A complete SCI results in no motor or sensory function below the level of the injury. An incomplete injury preserves some function, and the degree of recovery varies enormously. The ASIA Impairment Scale is used clinically to classify injury completeness and provides an important baseline for predicting and monitoring recovery.

Key Goals of Physiotherapy

Physiotherapy goals following SCI depend on the level and completeness of injury. For cervical injuries, goals may include maximising upper limb function, respiratory management, and facilitating the use of assistive technology. For thoracic and lumbar injuries, goals typically focus on mobility, transfers, wheelchair skills, standing, and where possible walking. Functional electrical stimulation has an emerging evidence base for improving motor function in SCI.

References

van Middendorp, J.J. et al. (2011). A clinical prediction rule for ambulation outcomes after traumatic spinal cord injury. Journal of Neurology, Neurosurgery & Psychiatry, 82(1), 87–93. https://doi.org/10.1136/jnnp.2010.218842

Mehrholz, J. et al. (2012). Locomotor training for walking after spinal cord injury. Cochrane Database of Systematic Reviews, Issue 11. https://doi.org/10.1002/14651858.CD006676.pub3

Ho, C.H. et al. (2014). Functional electrical stimulation and spinal cord injury. Physical Medicine and Rehabilitation Clinics of North America, 25(3), 631–654. https://doi.org/10.1016/j.pmr.2014.05.001