What it is
A short, honest summary.
- —Damage to the cord — traumatic or otherwise — that disrupts signal between brain and body.
- —Injury level and completeness determine the starting picture, not the ending one.
- —Rehabilitation works the body and the nervous system together, for years.
What families notice
The signals worth taking seriously.
- 01Loss of sensation or movement below a level on the body
- 02Bladder, bowel, or sexual function changes
- 03Spasticity — involuntary tightness or movement
- 04Skin pressure concerns from immobility
- 05Mood, identity, and relationship changes
My approach
How the work is structured.
- —Functional goal-setting — transfers, self-care, mobility, return to work where possible.
- —Strength, endurance, and skill training scaled to the injury level.
- —Caregiver education on transfers, pressure care, and bowel/bladder routines.
- —Coordination with the physiatrist, urologist, and occupational therapist as needed.
What recovery looks like
A plain-language picture.
“Recovery in SCI is uneven and often surprising. Some return comes fast; some takes years. Rehab is not a sprint, and it is not finite.”
FAQ
Common questions, answered briefly.
- Is there a time limit on recovery after SCI?
- No. While most spontaneous return occurs in the first 18 months, function continues to improve with sustained, skilled work.
- Will my family member walk again?
- Honestly, it depends on the injury level and completeness. We set near-term functional goals and revise as the picture sharpens.
For clinicians
Clinical detail, assessment and evidence.
Clinical summary
The picture in clinician register.
SCI disrupts ascending and descending cord pathways; the neurological level and completeness (ASIA Impairment Scale) frame the initial picture but not the ceiling. Rehabilitation is function-led and long-horizon, addressing motor and skill retraining alongside bladder, bowel, skin and autonomic management. Spontaneous recovery is greatest in the first 12-18 months, but skilled work adds function well beyond it.
Terminology
Terms worth being precise about.
- ASIA Impairment Scale
- Standard classification of injury completeness, A through E.
- Neurological level
- The lowest segment with intact motor and sensory function.
- Autonomic dysreflexia
- A potentially dangerous hypertensive response to a noxious stimulus below the lesion.
- Neurogenic bladder/bowel
- Loss of normal voiding control requiring a structured management routine.
Assessment & measures
What the first sessions measure.
- —ISNCSCI / ASIA classification.
- —SCIM (Spinal Cord Independence Measure); transfer and mobility assessment.
- —Spasticity (Modified Ashworth Scale); skin and seating review.
Red flags
Signs that need urgent escalation.
- Autonomic dysreflexia — severe hypertension with headache; a medical emergency. Find and remove the trigger.
- A developing pressure injury.
- A new ascending neurological level — consider a syrinx.
Referral & MDT
When and to whom to refer.
Physiatry / spinal-injury service. Urology; specialist seating and pressure-care; occupational therapy; psychology.
Evidence
References and guideline anchors.
- Activity-based therapy in SCI — PLACEHOLDER — verify against current guidelines before launch.