The case study of Mr. Seiler sought to show that rehabilitation of traumatic SCI patients occurs not only within the early post-acute rehabilitation phase, but involves a continual process that begins at the time of the accident, extends through acute care and beyond to a patient’s optimal recovery. Such a recovery benefits from contributions of both health professionals and the patient. All of the rescue personnel and health care team members involved in this process, in addition to the patient him or herself, have a major impact on the functional outcome.
The rescue team's utilization of appropriate spine stabilization devices and careful extraction also prevented damage.
While the degree of a patient’s functional recovery is first and foremost related to the type and severity of injury, decisions made early on can have a significant effect on an individual’s recovery.
Timely and appropriate interventions will support optimal outcomes, while early missteps can be detrimental to the patient, potentially causing further harm to the spinal cord.
Mr. Seiler’s case can in many ways be considered an ideal example. The final results of his rehabilitation process in general and the Rehab Cycle specifically were remarkable. Mr. Seiler achieved all of the goals that were set, and many were achieved beyond all expectations. The fact that the SCI was incomplete gave Mr. Seiler good odds for a full recovery. However, the type of injury was far from the only significant factor in such a positive outcome.
Many other human elements in the process were also of importance in his recovery. Mr. Seiler’s co-workers’ decision to not move him and immediately contact emergency services helped to minimize further possible damage. The rescue team’s utilization of appropriate spine stabilization devices and careful extraction also prevented damage. Their decision to evacuate by helicopter offered the benefits of rapid transport (allowing acute care to begin sooner) and minimized unnecessary movement that would have occurred with ground transportation.
...decisions made early on can have a significant effect on an individual's recovery.
In the process of this rehabilitation the patient’s contribution also has a vital role to play in achieving the best possible outcomes. While it’s impossible to say to what degree Mr. Seiler’s personal factors helped him to recover, they were without a doubt very important. His good general health, physical strength, willpower, discipline and motivation all worked to his benefit during his rehabilitation.
His good general health, physical strength, willpower, discipline and motivation all worked to his benefit...
In the face of initial doubt and fear, Mr. Seiler — with some gentle words from his physician — soon felt that he could and would overcome his situation. The health care professionals continued to support him psychologically through their own optimism and motivation, even adapting their interventions (walking on his own, for example) to match his determination; a strategy that in the end succeeded.
While Mr. Seiler’s case offers a clear example of a successful recovery of a traumatic SCI patient, it is not representative for many other victims of spinal cord injury. Research on and planning and implementing of interventions that offer the best odds for optimal recoveries amongst traumatic SCI patients will help to augment natural recovery. 76
Given the importance of each of the members of the medical teams managing such patients from the rescue through the Rehab Cycle, the best recoveries will continue to depend on their knowledge, training, skill and expertise.