Spinal Cord Rehabilitation

Treatment Team

Occupational therapist Tom Kunz helps a patient exercise fine motor movements.

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The Patient and Family Members
The rehabilitation patient is the most important member of the rehabilitation team. Active participation by the patient and family in goals planning and therapy is key to effective rehabilitation. With the patient's permission, the rehabilitation team shares patient progress assessments with family members involved in patient care so they understand overall progress, expectations for further rehabilitation and discharge goals.

Physiatrists
Physiatrists are physicians specialized in physical medicine and rehabilitation, and are responsible for the patient's overall medical care. They coordinate rehabilitation therapies, services, and the care patients require from other Mayo Clinic physicians. All Mayo Clinic physiatrists have completed a residency in Physical Medicine and Rehabilitation, are certified by the American Board of Physical Medicine and Rehabilitation, and have subspecialty certification in spinal cord rehabilitation.

Psychologists
Rehabilitation psychologists are trained in the psychology of adjustment to disability. They have a Ph.D. and a certification from the American Board of Rehabiltation Psychology. Rehabilitation psychologists assess how the patient is coping. They work with the patient, the family and other members of the rehabilitation team to help patients adjust to their disability and plan for the future. Frequent areas of intervention include stress management, coping with loss, sexuality and vocational planning.

Rehabilitation nurses
Nursing staff includes registered nurses (RNs) specialized in Spinal Cord Rehabilitation, licensed practical nurses, patient care assistants and nursing students. Rehabilitation RNs assess each patient's ongoing physiological and emotional status as well as progress with functional rehabilitation. Nursing staff assist patients with bowel and bladder management, preventive skin care, surgical-incision care, administer prescribed medications and assist patients with activities of daily living. The rehabilitation nurse's primary goal is to teach the patient, rather than do for the patient. Nursing personnel help patients practice the techniques and skills learned in therapy sessions. The rehabilitation RN assists patients in preparing for discharge to home.

Physical therapists
Spinal cord injury causes weakness, incoordination, and fatigue. A physical therapist helps the patient regain muscle function, increase mobility and learn how to use the appropriate adaptive equipment. Physical therapists have specialized expertise in wheelchairs and functional electrical stimulation. Many physical therapists who work with patients who have spinal cord injuries are involved in research activities.

Occupational therapists
Occupational therapists help patients develop the functional abilities needed in daily life, such as self-care and home management. Occupational therapists also address swallowing, upper extremity functioning, cognition and safety, vision and perceptions. Occupational therapists have special expertise in wheelchairs, rehabilitation after upper extremity functional restoration surgery, and driving after spinal cord injury.

Respiratory therapists and respiratory therapy technicians
Patients with spinal cord injury involving the neck or upper back often have difficulty coughing effectively. Individuals who have cervical injuries affecting C1-C4 also have difficulty breathing. Respiratory therapists evaluate, treat and care for patients with breathing disorders, and are responsible for respiratory care treatments. For patients who require ventilators to breathe after spinal cord injury, respiratory therapists help insure the patient, family, friends or support system know how to use the ventilator.

Recreational therapists
A critical part of recovery after spinal cord injury is the ability to return to social, family and recreational activities. In many instances, a spinal cord injury changes how someone can participate in hobbies and family activities. A recreational therapist helps patients adjust to the hobbies and activities they participated in before their injuries, to develop new skills and interests, and get involved in the community through reintegration trips. Recreational therapists provide opportunities to apply learned skills from other therapies to leisure activities.

Speech-language pathologists
Some spinal cord injuries can affect speech, or may occur with a brain injury. In these situations speech-language pathologists will evaluate speech and language abilities. The speech pathologist assists with the skills necessary for communication, or possibly develops alternative methods of communication.

Social workers
Medical social workers assist the patient and family in various ways. Social workers counsel patients and family members, provide emotional support and offer information about economic resources and community agencies. They also help in discharge planning when the patient is transferring to a care agency and follow up after discharge.

Chaplains
Caring for the spiritual needs of patients is very important. Chaplains are on call 24 hours a day to coordinate and provide spiritual or religious support for patients and their families throughout the recovery process.

Dietitians
Adequate nutrition is critical to recovery after spinal cord injury. A registered dietitian regularly visits patients to help them make healthy food choices and to manage special dietary needs.