06 | Recovery After Traumatic SCI

Discussion

The case study of Mr. Seiler, who became tetraplegic after falling down a side of a mountain, exemplified that optimal recovery of persons with traumatic spinal cord injury (SCI) does not begin at the early post-acute rehabilitation phase but already at the time of the accident and extends through to acute care and beyond. Moreover, optimal recovery depends on the contributions of health professionals and the injured person alike.

Actions of the of the rescue team, members of the acute medical team and rehabilitation team as well as the involvement of the injured person him or herself have a major impact on the overall functioning outcome.

"The rescue team's utilisation of appropriate spine stabilisation devices and careful extraction also prevented damage."

While the degree of an injury person’s functional recovery is first and foremost related to the type and severity of injury,1 2 8 decisions made early on can have a significant effect on the person's recovery. Timely and appropriate interventions support optimal outcomes, 3 4 5 6 7 while early missteps can be detrimental to the injured person, potentially causing further harm to the spinal cord.

"...decisions made early on can have a significant effect on the person's recovery."

In Mr. Seiler’s case the decision of his colleagues, who found him on the mountainside, to not move him and immediately call the rescue service set the stage for a positive and speedy recovery. This critical decision helped to minimize further potential damage. Subsquently, the rescue team’s utilization of appropriate spine stabilisation devices and careful extraction also prevented damage. Their decision to evacuate Mr. Seiler by helicopter offered the benefits of rapid transport (allowing acute care to begin sooner) and minimised unnecessary movement that would have occurred with ground transportation. In addition, the fact that Mr. Seiler's SCI was incomplete increased his chance for full recovery. However even in Mr. Seiler's case, the type of injury and rapid access to appropriate care were not the only factors that contributed to his successful rehabilitation outcomes.

The results at the end of Mr. Seiler's Rehab-Cycle® were remarkable. He achieved all of the goals he and his rehabilitation team set, many beyond all expectations. While it is difficult to prove the extent Mr. Seiler’s personal factors promoted his recovery, these factors were without a doubt very important. His good general health, physical strength, willpower, self-discipline and motivation benefited his rehabilitation.

"His good general health, physical strength, willpower, self-discipline and motivation benefited his rehabilitation."

While Mr. Seiler’s case provides a clear example of successful recovery of a person with traumatic SCI, it is not representative of many others with SCI. However, there is reason for optimism. For all persons living with SCI, advances in pharmacological and other interventions, such as functional neuromuscular stimulation (use of electrical stimulation to activate paralysed muscles) and effective physical body training, all strategies that promote the natural recovery of the body, enhances the prospects for better rehabilitation outcomes and ultimately improved recovery. 12 14

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