Spinal Cord Injuries (SCI) can be defined as a traumatic or non-traumatic event that leads to neural damage that influences motor-, sensory – and respiratory function, as well as bladder -, bowel – and sexual function. The neurological interruption also affects the individual’s blood pressure, skin integrity and ability to regulate temperature.

SCIs don’t only have an impact on the individuals’ physical – and emotional well-being, but it also has a considerable impact on families, communities and healthcare systems worldwide. Literature indicates the peak age between 12 and 30 years, with an average life span as 30.2 years following injury.

SCI, most commonly, results in paraplegia or tetraplegia. Paraplegia is the loss in motor and/ or sensory function in the lower limbs (LLs) and trunk. While tetraplegia includes the upper limbs (ULs) to the motor and/ or sensory loss of the LLs and trunk.

Physiotherapy management

The acute management and rehabilitation of SCI depend on the level and type of injury to the spinal cord. Individuals with a SCI often require initial treatment in an intensive care unit with the rehabilitation process typically starting in the acute care setting, followed by extended treatment in a specialised Spinal Injury Unit.

The management of an individual with SCI is complex and lifelong requiring a multidisciplinary approach. A functional, goal-oriented, interdisciplinary, rehabilitation programme should enable the individual with a spinal cord injury to live as full and independent a life as possible. Physiotherapy, occupational therapy, speech and language therapy, rehabilitation nurses, social workers, psychologists and other health work as a team to decide on goals with the individual and develop a plan of discharge that is appropriate for the individuals level of injury and circumstances. 

Five key steps in the management of individuals with SCI are;

  • Assessing impairments, activity limitations and participation restrictions
  • Setting goals relevant to activity limitations and participation restrictions
  • Identifying key impairments that are limiting achievement of goals
  • Identifying and administering physiotherapy treatments (strengthening, joint mobility, motor skill development, cardiovascular fitness, respiratory functioning, pain managing)
  • Measuring the outcome of treatments

The management of individuals with a SCI can be divided into 3 Phases;

  1. Acute,
  2. Sub-acute (Rehabilitation), and
  3. Chronic (Long Term).

During the acute and subacute phases of treatment, rehabilitation strategies focus more on prevention of secondary complications, promoting neuro recovery, addressing underlying impairments and maximizing function. In the chronic phase, compensatory or assistive approaches are often used

We work mainly on


  1. Bed mobility
  2. Sitting balance training
  3. Transfers training
  4. wheelchair mobility skills
  5. Standing balance
  6. Treadmill walking
  7. Waling training with orthotics

Case studies


2. Paraplegic rehab video of Megha Agrawal T 12# ASIA Type B 2019

Published by GajananBhalerao

DR. GAJANAN BHALERAO (PT) MPTh Neuro, NDT Adult (USA), Motor relearning (Australia), Aquatic therapist (Switzerland). Associate professor at Sancheti Institute College of physiotherapy, Shivajinagar, Pune. Founder Director of "School of neuro rehab and aquatic therapy" , speciality centre for neuro rehabilitation of stroke, brain and spinal cord injury. Mobile : 9822623701 Email:Gajanan_bhalerao@yahoo.com, gajanan.neurophysio@gmail.com

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