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Rehabilitation After a Spinal Injury


Salvador E. Portugal

, DO, New York University, Robert I. Grossman School of Medicine

Last full review/revision Aug 2021

Recovery from spinal cord injury Overview of Spinal Cord Disorders Spinal cord disorders can cause permanent severe problems, such as paralysis or impaired bladder and bowel control (urinary incontinence and fecal incontinence). Sometimes these problems can... read more depends on the location (level) and degree of damage. The higher the level of injury, the greater the physical impairment and need for rehabilitation Overview of Rehabilitation Rehabilitation services are needed by people who have lost the ability to function normally, often because of an injury, a stroke, an infection, a tumor, surgery, or a progressive disorder ... read more . Injury at the level of the chest or below causes weakness or paralysis of the legs (paraplegia). Injury at the level of the neck causes weakness or paralysis of all four limbs (quadriplegia). If the level of injury is very high in the neck, the muscles that control breathing may be paralyzed, and a ventilator may be needed to assist breathing. Also, sensation is impaired below the level of injury, and bladder and bowel control is usually lost.

The two most important aspects of caring for people with quadriplegia or paraplegia are the following:

Measures are also taken to prevent muscles from shortening (contractures).

People with paraplegia can live independently. Range-of-motion and strengthening exercises of the arms and hands enable them to use a wheelchair and to transfer from bed to a wheelchair and from a wheelchair to a toilet or a car seat. They can do many activities of daily living on their own, and many return to work. Some paraplegics can drive a car with the help of assistive devices.

People with quadriplegia can use a motorized wheelchair to move independently, but they must be lifted into the wheelchair manually or mechanically. Some quadriplegics can move their hands or fingers slightly and thus can operate the motorized wheelchair with a hand switch. If the hands and arms are completely paralyzed, quadriplegics can use a special device that enables them to control the motorized wheelchair with chin movements or even their breath. However, this method requires very intensive training. Most quadriplegics need support 24 hours a day.

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The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

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