At Propel Physiotherapy, the treatment of people living with spinal cord injury (SCI) begins with a detailed neurological physiotherapy assessment, application of meaningful outcome measures, and the development of salient goals. Throughout this process, it may be determined appropriate that the client living with SCI use specific pieces of therapeutic equipment or assistive devices for SCI rehabilitation.

Assistive Devices for Incomplete Spinal Cord Injuries

Individuals with an incomplete spinal cord injury are likely to see the biggest functional benefits from gait-training, and depending on the level of injury, may be more likely to walk with or without a mobility aid. Depending on the level of function during initial assessment, people with incomplete SCI may be prescribed a walker as a mobility aid around the house, and have a manual wheelchair for travelling longer distances.

On that same note, with physiotherapy and exercise, the client living with SCI may also progress their assistive devices to items that require less external stability, and more postural control from the individual’s efforts. These assistive devices may include, but are not limited to, walking poles, single point canes, and ankle foot orthoses. These decisions are made with the client and through the guidance of our highly experienced clinicians.

During physiotherapy treatment sessions at Propel, some of the tools and techniques we use to help re-train walking include: parallel bars, body-weight support harness, treadmill training (using the body-weight support harness), strengthening and conditioning exercises, balance work, standing frame, functional electrical stimulation, biofeedback, plinth or mat work, NDT/Bobath manual facilitation of normal movement, and hydrotherapy.

By assessing a person’s walking quality, the clinician will recommend and carryout certain techniques and treatments that encourage optimal walking efficiency and function, depending on the client’s goals.

For instance, if a person living with incomplete SCI has difficulty weight bearing through one lower extremity and favours one leg, it may be appropriate to encourage equal weight bearing via NDT/Bobath manual facilitation, paired with body-weight supported standing or walking.

People living with complete SCI may still benefit from assisted gait training, however, the evidence suggests that the benefits would be more systemic.

Assistive Devices for Complete Spinal Cord Injuries

Individuals with complete injuries are likely to require a wheelchair. Having the right wheelchair is critically important for independence, function, quality of life, and health. At Propel Physiotherapy, we have extensive experience conducting wheelchair assessments, and prescribing appropriate seating devices.

To support someone in becoming as independent as possible, we practice skills in physiotherapy sessions like getting over a curb, avoiding obstacles, using steep ramps safely and any other skills that they feel will be useful for them.

Depending on the person’s upper extremity, trunk, and secondary neurological symptoms (e.g., tone, spasticity), the client may be able to successfully transfer from the floor to seat, independently or with modified assistance.

In this video, our client is practicing a floor to seat transfer with bench. Nails the lift off, touch hard on the landing. Here is a great example of functional strength meeting setup and technique. This is one of the most difficult transfers and requires practice, persistence, and training!

The wheelchair skills and transfers learned/ applied in clinic may speak directly to other complimentary physical activities a wheelchair user with SCI may participate in. Many amazing adaptive sports like wheelchair basketball, volleyball, tennis and rugby require higher level wheelchair skills, so the client’s rehab program can also be geared towards participating in organized sport.

The Ontario Wheelchair Sports Association and ParaSport Ontario are fantastic resources to explore the growing landscape of adaptive sport and recreation.

Improving a person’s overall strength, aerobic fitness, and conditioning, can assist in providing health benefits and decrease the likelihood of future medical complications. In fact, research continues to support the efficacy of regular, planned exercise of the aerobic and musculoskeletal system in people living with SCI.

Adaptive sports spinal cord injury exercise guidelines SCI Action Canada Propel Physiotherapy Etobicoke Physiotherapy Pickering

The SCI Action Canada website is a great tool for those in search of basic activities they can participate in to stay healthy, while living with SCI. In summary, the body of evidence suggests people living with SCI should engage 20 minutes of aerobic exercise twice a week, and resistance/strength training twice a week, with a focus on 3 sets per major muscle group.

See SCI action Canada’s guidelines for more detail or check out our post on maintaining heart health with spinal cord injury.

Propel Physiotherapy’s clinicians will be able to assist in accomplishing these goals by using different pieces of adaptive or modified equipment. We host a variety of equipment such as: the Nu-Step, the Lite-Gait Body Weight Support system, recumbent stationary cycle, MotoMed, resistance bands, and an accessible resistance machine.  Your clinician will be able to determine what equipment best suits your goals.

At Propel Physiotherapy, we combine our knowledge and passion for working with people with spinal cord injury with evidence-informed assessment, treatments, exercises, and technology. This enables us to provide high-quality comprehensive care in both our clinics and out in community settings.

Written by

Propel Physiotherapy
Propel PhysiotherapyIntegrated Healthcare Team
A special thank to our summer intern Laura Sawula from the University of Toronto’s Physical Therapy program for helping us put together this blog post as part of her placement. Laura is on instagram as @lsawula.