Rehabilitation of the patient with spinal cord injury

Abstract

ALTHOUGH NEUROLOGIC IMPROVEMENT may occur in survivors of spinal injured patients, an acute and comprehensive rehabiiitation effort is necessary to insure return to a productive life!' Depending on the level of the lesion, a quadriplegic patient requires between 200 and 300 days of inpatient rehabilitation efforts, whereas a paraplegic needs 100-160 days2, ~4.15 The socioeconomic impact on patient and family is very profound. Associated injuries and their complications, along with pulmonary embolism, are major causes of early death in spinal cord injury, especially in quadriplegia. Renal failure is the leading cause of death in later stages, along with personality problems often resulting in suicide. This demonstrates the importance of psychological rehabilitation. ~ Following the acute phase, various causes of readmission include urologic and pulmonary complications, pressure sores and socioeconomic maladjustment. Rehabilitation of the spinal cord injury patient begins after an early phase of acute care and focuses on physical restoration, vocational and educational exposure and, ultimately, social adjustment and return to the community.