Lisa's Story

Lisa lived sports. Athletics played a large role both in her private and professional life, as an accomplished athlete and a respected high school physical education (and geography) teacher. Following her spinal cord injury (SCI), Lisa’s fitness and athleticism were significant contributors to her overall recovery. At 35, she regularly practiced a wide variety of sports — skiing, mountain biking, tennis, volleyball and climbing, to name a few.

Sports and athletics have always been incredibly important to me, to my relationship to the world — for my self-perception and body awareness and fitness, for the thrill and challenge of competition and for all of the social aspects. And obviously it’s played a professional role as well, in my career as a teacher — introducing sports to young people has been truly rewarding. A combination of a career I love and a life passion.

Lisa

Read more: Lisa's Story

Assessment

During the initial assessment phase, both patient and health professional perspectives were evaluated for each of the ICF components: body structures and functions, activity, participation, and environmental and personal factors.

Given her injuries and prior rehabilitation, Lisa felt that while she had made some progress, there was still much which could be improved. Medically, she had many of the typical impairments associated with a spinal cord injury at the Th8 level. Pain, reduced muscle power in the upper extremity, a lack of exercise tolerance, unstable blood pressure and a moderate degree of spasticity were impaired body functions that would need to be addressed in this Rehab Cycle.

Read more: Assessment

Goal-Setting

Based on the perspectives from the assessment, three Cycle Goals were defined that would work towards Lisa’s Service Program Goal of independence in daily living and the previously established Global Goal of community reintegration. To achieve this, both Lisa and the healthcare providers agreed that mobility and self-care — fundamental aspects of independent living — required further rehabilitative efforts.

Read more: Goal setting/determination of intervention targets

Assignment and Intervention

Assignment

Specific interventions for each of the targets were defined and assigned to the appropriate members of the healthcare team. In this Rehab Cycle, in addition to the standard healthcare professionals, a sports therapist, physical therapist and psychologist would be added to meet Lisa’s athletic, physical therapy and psychological needs.

Figure 5 offers greater detail on the assignments for specific interventions in Lisa’s Cycle.

Read more: Assignment and Intervention

I’ve improved so much — my muscle power, using my wheelchair, transferring myself, and especially in sports. Immediately after the accident, I absolutely knew that sports would continue to be a very big part of my life. It offers me an opportunity to move, to feel joyful, to meet other people and to really experience my improvements as I recover.

I feel like my fear of falling is almost gone; I think the Feldenkrais helped the most with this.

Lisa, at the end of the Rehab Cycle

I absolutely knew that sports would continue to be a very big part of my life.
Read more: Evaluation

Discussion

Sports and other athletic activities can play an important role in the rehabilitative process of spinal cord injury patients. Beyond enhancing physical fitness and functioning, sports can benefit psychological and emotional functioning, promote quick returns to the activities of daily life and community reintegration, and reduce SCI-associated morbidities.15810 Thus, sports can be seen as a significant contributor to the overall health maintenance and health promotion of patients.

...interventions had an introspective and calming effect, helping her to adapt to her new life situation and even to alleviate some of her falling fear.
Read more: Discussion

Sports Intervention for SCI patients

Following a spinal cord injury (SCI), at the start of rehabilitation a reduced physical and psychological condition is the norm.12 Physical capacity has been defined as the “combined ability of the cardiovascular, respiratory and musculoskeletal systems to attain certain levels of activity.”2 Such capacity of an SCI patient is closely related to the performance of the activities of daily living. The often extreme reductions in performance of daily activities combined with a sedentary lifestyle results in inadequate maintenance of a patient’s physical capacity.3 The physical deconditioning and premature aging that can occur in SCI patients can be extreme. This includes increased rates of secondary conditions such as cardiovascular and respiratory diseases, bone and joint diseases, pain and obesity.45 The end result is more complications as well as reduced levels of functioning and quality of life.6

Read more: General Introduction