Neurológia pre prax 3/2009

Examination and rehabilitation procedures in patients after spinal cord lesion

The physiotherapy of the spinal cord injuries takes, due to its high demands in costs, skills and specific needs, place at the specialized wards – the Spinal cord units. With respect to those requirements the special ASIA neurological assessment (performed according to the American Spinal Injury Association, ASIA) has been currently used. This examination permits an assessment of the level and extent of the neurological impairment. The rehabilitation begins immediately the SCI patients are admitted to the SCU. The main attention is paid to the respiratory and pain management. A wide range of specific physiotherapy methods have been used in order to minimize neurological and functional deficits after SCI (e. g., techniques based on the clinical neurology approach, performance of passive and active movements, verticalization, physical therapy, functional electrical stimulation, using MotoMed and Lokomat devices etc). The specialized physiotherapeutic management during the acute, sub-acute and chronic phase after SCI has been focused on a recovery of disturbed functions, a restoration of the remaining muscle potential, a creation of compensatory mechanisms to achieve as high as possible level of self-sufficiency and especially to reach the acceptable quality of life.

Keywords: spinal cord injury, ASIA assessment, physiotherapy, Vojta reflex therapy, Lokomat, occupational therapy.