The modern rehabilitation of patients with spinal cord injuries.
A spinal cord injury is a major catastrophe, causing many changes in the patient's lifestyle. These injuries commonly occur to people who were previously active and independent, but after the injury become largely dependent on others for their basic needs. What is needed for such patients is a comprehensive, integrated program of rehabilitation involving the participation of an entire team of specialists, including physiotherapists. This article presents the principles for making the right choice of physiotherapy techniques, which should be adapted to the needs and clinical condition of the given patient. Five stages of rehabilitation are described here. Immediately after the injury (Stage 1) there is primarily loss of function due to the neurological injury. The primary goal of physiotherapy at this stage is to reduce the negative consequences of immobilization. In the early phase of rehabilitation proper (Stage 2) the patient can now perform some exercises outside the bed. Long-range goals are now established. Stage 3 is in many respects the most active phase of rehabilitation. At this stage advanced skills in moving from bed to wheelchair are learned, and the patient takes the first steps. In Stage 4, thpatient's return to home is planned. The exercise plan includes family training, modification of the home environment, home exercises, etc. In Stage 5, the patient is at home, returning to the clinic periodically for maintenance exercises.
Knapik
Henryk
H