Physiotherapy & Occupational Therapy

Physiotherapy (PT) and Occupational Therapy (OT) are core pillars of spinal cord injury (SCI) rehabilitation. They do not “cure” the injury, but they dramatically improve function, independence, health, and long-term quality of life. Here’s a clear, structured overview.

1. Physiotherapy (PT) in Spinal Cord Injury

Physiotherapy focuses on body movement, strength, endurance, mobility, and preventing complications.

🔹 Goals of Physiotherapy

• Maintain and improve muscle strength above the injury level
• Prevent muscle wasting and joint contractures
• Improve sitting balance and postural control
• Train transfers (bed ↔ wheelchair, wheelchair ↔ car)
• Improve respiratory capacity
• Build cardiovascular endurance
• Improve gait, if possible (in incomplete injuries)
• Prevent complications: pressure ulcers, DVT, spasticity
• Support neuroplasticity and recovery

🔹 Common Physiotherapy Techniques

1. Range of Motion (ROM) Exercises

Prevents stiffness, contractures, and joint deformities.

2. Strengthening Exercises

For muscles above the injury level + preserved muscles below it.

3. Mat Activities

• Rolling
• Sitting balance
• Trunk control
• Bridging

4. Gait Training

If injury is incomplete (AIS B/C/D):

• Parallel bars
• Walkers
• Robotic exoskeletons
• Body-weight–supported treadmill training (BWSTT)

5. Functional Electrical Stimulation (FES)

Electric stimulation to activate paralysed muscles:

• Improves circulation
• Prevents atrophy
• Helps cycling, standing, stepping

6. Respiratory Physiotherapy

Especially important for C1–T6 injuries.

7. Hydrotherapy

Warm water reduces spasticity, improves movement.

8. Wheelchair Mobility Training

Learning:

• Propulsion
• Turning
• Ramps
• Wheelies (for high-level independence)

2. Occupational Therapy (OT) in Spinal Cord Injury

OT focuses on daily living skills, hand function, independence, and adapting the environment.

🔹 Goals of Occupational Therapy

• Improve hand function (especially in tetraplegia)
• Teach ADLs (Activities of Daily Living)
• Train in using assistive equipment
• Prepare for home & work reintegration
• Cognitive/psychological adaptation
• Environmental modifications

🔹 Common OT Interventions

1. Hand Function Training

For cervical injuries:

• Tenodesis training
• Grip strengthening
• Fine-motor activities
• Splinting and orthotics

2. Activities of Daily Living (ADL) Training

• Eating
• Dressing
• Grooming
• Toileting
• Bathing
• Writing & computer use

3. Assistive Devices

• Universal cuffs
• Adaptive cutlery
• Wheelchair accessories
• Transfer boards
• Environmental control units (ECU)
• Smart-home integration

4. Home Modification Planning

• Ramps
• Bathroom modifications
• Bed and toilet adaptations

5. Wheelchair Seating & Positioning

OT ensures correct:

• Cushion selection
• Pressure management
• Posture optimization

6. Community Reintegration

• Using public transportation
• Vocational training
• Leisure activities

3. How PT & OT Work Together

They complement each other — you need both for the best recovery outcome.

4. Evidence: Why PT & OT Are Essential

Research consistently shows: ✔️ Early, intensive rehabilitation increases neuroplasticity ✔️ Regular PT/OT reduces complications by 50–70% ✔️ People who complete full rehab regain more independence in:

• Mobility
• Hand use
• ADLs
• Community participation

Even in complete injuries, PT + OT dramatically improves quality of life, health, and longevity.

5. Want a Customized PT/OT Plan?

I can create a personalized rehabilitation plan based on:

• Your injury level (C, T, L?)
• Complete or incomplete?
• Time since injury
• Strength in arms/legs
• Spasticity level
• Current abilities (standing, walking, using a wheelchair)
• Goals (independent living, walking, hand function)