At MobilityWorks, we typically hear from individuals affected by a spinal cord injury (SCI) once their condition has stabilized, prior to their entering rehabilitation, and/or when they are just beginning to think about how to make accessible changes in their lives and homes.
Often, the greatest level of uncertainty comes from the unpredictability of healing/rehabilitation timelines.
One thing is certain though…your transportation needs will likely change over time. We can help though. Our Certified Mobility Consultants will work with you to assess your current physical condition and offer both short and long-term mobility options for you to consider.
Some individuals affected by a spinal cord injury will need to use a wheelchair for just a period of time. In other cases, people may only need a wheelchair or scooter for occasional situations in which they will need to move around a lot.
In either of these instances, the focus needs to be on how to equip yourself with what you need today. If your need is truly very short-term, then renting a wheelchair accessible often makes the most sense.
If your transition is going to be longer than a few months, then you may want to consider a strategy for how to make a purchase now that will make the most financial sense when you look to re-sell in the future.
An example might be to consider buying a used wheelchair van now and then selling or trading that van when full-wheelchair access is no longer needed.
In other instances, you may know that the prognosis is that you will be a permanent full-time wheelchair user. In this instance, you may want to consider purchasing either a new or pre-owned vehicle that you can plan on having for several years.
At this point, our Certified Mobility Consultants can work with you to evaluate the size/weight of your wheelchair, as well as factors such as the number of people that will be transported in the vehicle, where it's parked/garage and your budget to offer you options for long-term mobility solutions.
You will also want to consider if you will be able to drive again. If so, then the choices that you make may potentially be very different. If you think that the potential for driving is there, then we recommend that you look into solutions that will allow for the addition of adaptive driving aids such as hand controls and/or transfer seats.
At MobilityWorks we pride ourselves on developing lasting relationships with our customers. We want to ensure that you have the most appropriate mobility equipment solutions for your needs—today and in the future.Spinal Cord Injury Overview
The vertebrae normally protect the soft tissues of the spinal cord, but they can be broken or dislocated in a variety of ways that put harmful pressure on the spinal cord. Injuries can occur at any level of the spinal cord. The portion of the cord that is injured and the severity of the damage to the nervous tissue will determine which body functions are compromised or lost.
Motor vehicle accidents and catastrophic falls are the most common causes of physical trauma that can cause breaking, crushing or pressing on the vertebrae. Physical trauma can cause irreversible damage at the corresponding level of the spinal cord and below. Severe trauma to the spinal cord resulting in paralysis of most of the body, including the arms and legs, is called tetraplegia (or quadriplegia). Trauma to the thoracic nerves in the upper, middle or lower back results in paralysis of the trunk and lower extremities known as paraplegia.
Traumatic spinal cord injury begins with a sudden, mechanical blow or rupture to the spine that fractures or dislocates vertebrae. The damage begins at the moment of the primary injury, when the cord is stretched or displaced by bone fragments or disc material.
Spinal cord injuries can be classified as incomplete or complete injuries. With an incomplete injury, the ability of the spinal cord to convey messages to or from the brain is not completely lost. People with an incomplete injury retain some sensory function and may have voluntary motor activity below the injury site. A complete injury prevents nerve communications from the brain and spinal cord to parts of the body below the injury site. With a complete injury there is a total lack of sensory and motor function below the level of injury, even if the spinal cord was not completely severed.
Rehabilitation is essential for individuals with spinal cord injuries. Rehabilitation combines physical therapies with skill-building activities as well as counseling in order to completely support the individual who has suffered the spinal cord injury. The education and active involvement of the individual with the injury, as well as their family and caregivers are critical in the rehabilitation process.
A rehabilitation team is usually led by a doctor specializing in physical medicine and rehabilitation and often also includes social workers, physical and occupational therapists, recreational therapists and other specialists.
Physical therapy includes exercise programs geared toward muscle strengthening. Occupational therapy works to redefine fine motor skills, particularly those needed to perform daily living and personal care activities. Vocational rehabilitation assesses an individual's basic work skills, as well as their physical and cognitive capabilities as they relate to their ability to enter/return to the workplace.
In the initial phases of rehabilitation, the emphasis is placed on regaining communication skills and leg and arm strength. Doctors are able to predict with reasonable accuracy the likely long-term outcome for individuals with spinal cord injuries. With this knowledge, people can set achievable goals and make necessary preparations for the future.Spinal Cord Injury Research
Researchers have been focusing on several different spinal cord injury treatments; one of which is electrical stimulation of the spinal cord. The stimulation of the spinal cord delivers small bursts of a low-level electrical current to paralyzed muscles in order to help generate muscle contractions.
The stimulation is used to aid in exercise as well as to restore better breathing functions, grasping capabilities, transferring, improvement of blood flow to the skin and even standing.
In a recent study, funded in part by the National Institutes of Health and the Christopher & Dana Reeve Foundation, four individuals with paraplegia were able to move paralyzed muscles as a result of an electrical stimulation therapy to their spinal cords. The patients were able to voluntarily flex their toes, ankles and knees with stimulation. In addition, those movements were enhanced over time when combined with physical rehabilitation.
Two of the four participants in the study had complete sensory and motor paralysis. In these patients, the pathway that sends information about sensation from the legs to the brain is disrupted, in addition to the pathway that sends information from the brain to the legs in order to control movement. The researchers were particularly impacted by the fact that the patients responded positively to the electrical stimulation; as they had assumed that at least some of the sensory pathway needed to be intact in order for the therapy to be effective.
Researchers also point to the speed in which each study participant recovered voluntary movement as evidence that there may be dormant connections that exist in patients with complete motor paralysis. In addition, another important aspect of the study assessed the ability of each patient to modulate their movements in response to auditory and visual cues. All participants were able to synchronize leg, ankle and toe movements in unison with the rise and fall of a wave displayed on a computer screen, and three out of the four were able to change the force at which they flexed their leg, depending on the intensity of all three different auditory cues. The findings that the brain is able to take advantage of the few connections that may be remaining and then process the complicated visual, auditory and perceptual information tells researchers that the information from the brain is getting to the right place in the spinal cord. Researchers involved with the study say that the therapy has the potential to change the prognosis of people with paralysis even years after injury.
Researchers next plan to see if stimulation therapy can help patients with paralysis of upper limbs.
To learn more information stimulation therapy, please visit the National Institutes of Health website.Spinal Cord Injury Resources