Comprehensive rehabilitation of spinal cord injuries

Authors: Qi Yan, Xie Haixia; Chief Judge: Zhai Hua

Unit: Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center)

This popular science work is one of the popular science materials in the series "Don't be afraid of spinal cord injuries, there are ways to prevent and rehabilitate them"

Spinal cord injury is one of the most common causes of severe limb disability. The treatment of spinal cord injury mainly adopts comprehensive treatments such as drugs, surgery, rehabilitation, stem cells, etc. Among them, rehabilitation treatment is a basic and important part in promoting spinal cord injury patients to improve their quality of life and return to society.

Expert consensus recommendation: At different stages after spinal cord injury, patients should be managed by a multidisciplinary team. The best solution comes from the close connection between disciplines (Level III evidence, Level C recommendation). Only through the joint management of a multidisciplinary team and comprehensive rehabilitation can the physical, mental and social dysfunction of the rehabilitation subjects (sick, disabled, etc.) be eliminated or alleviated, so that their functions can reach or remain at the optimal level, enhance their ability to take care of themselves, return to society, and improve their quality of life. Comprehensive rehabilitation includes five aspects: medical rehabilitation, rehabilitation engineering, educational rehabilitation, vocational rehabilitation and social rehabilitation .

Medical rehabilitation is also called medical rehabilitation, which refers to the use of medical means to solve the functional disorders of the sick, injured and disabled to achieve the purpose of rehabilitation. Medical rehabilitation is the foundation and starting point of comprehensive rehabilitation and the fundamental guarantee for achieving rehabilitation goals.

The main focus of acute and subacute rehabilitation is to prevent secondary injuries and complications, promote and enhance nerve repair, maximize existing functions, and lay the foundation for long-term rehabilitation and training in the future. The chronic stage is mainly about learning skills and using compensatory or auxiliary measures.

- - - - - -

Rehabilitation Engineering Rehabilitation Engineering is the use of engineering methods and means to rehabilitate the disabled and promote their functional recovery, reconstruction or compensation. It is the main task of rehabilitation engineering in rehabilitation medicine. For some physically disabled people, engineering means are the main, and sometimes even the only, method of rehabilitation.

People with spinal cord injuries can rely on assistive technology to integrate with the environment and achieve more functional activities. Using walkers, modified tools in daily life, or using computers, phones, environmental control systems or life robots at work can reduce dependence on others and achieve a greater degree of return to family and society.

In a broad sense, educational rehabilitation refers to providing general education to people with physical disabilities, such as nine-year compulsory education and secondary and higher education; it also includes special education for the blind, deaf-mute, and mentally handicapped, such as schools for the blind, deaf-mute, and mentally handicapped.

The educational rehabilitation carried out by our hospital is targeted at school-age children and adolescents, with the goal of returning to school to study and live, and improving their ability to take care of themselves in daily life and their learning ability. We carry out educational referral and educational support in the "House of Hope" for people with spinal cord injuries, and carry out educational training for adolescents with spinal cord injuries every summer.

Vocational rehabilitation : assisting people with disabilities to properly choose the most suitable occupation that can fully develop their potential, and helping them to adapt to and be competent in work, gain independent economic ability, and contribute to society. Through rehabilitation, help people with disabilities or injuries to find employment or re-employment, and promote their participation or re-participation in society.

Our hospital has developed a vocational rehabilitation process to help spinal cord injury patients return to work and achieve the vocational rehabilitation goals of re-employment and entrepreneurship by conducting comprehensive vocational ability assessments and carrying out vocational ability training.

Vocational rehabilitation can effectively help the injured return to work and achieve the goal of re-employment and entrepreneurship. The injured who have been re-employed after vocational rehabilitation in our hospital are distributed in various fields of work, including artificial intelligence, finance, engineering, medical care, social welfare and other fields. Some injured people have devoted themselves to the cause of disabled sports and achieved excellent results in major domestic and international sports events.

Social rehabilitation is to safeguard the rights and dignity of the disabled, help them solve various difficulties, improve their living and welfare conditions, and accept them into the comprehensive social life. It includes establishing barrier-free environment, improving economic environment and legal environment. Social rehabilitation is the ultimate goal and guarantee for achieving medical rehabilitation, educational rehabilitation, assistive device engineering and vocational rehabilitation.
- - - - - -

Comprehensive rehabilitation of spinal cord injury is of great significance to improving the daily living ability of patients with spinal cord injury, achieving functional reconstruction, reintegrating into society, and realizing their own life value. If one person with spinal cord injury achieves rehabilitation, the whole family can be liberated, and the injured and their families can return to work, thus creating more value for society.

(Some pictures in this article are from the Internet)

References:

[1]Gélis A, Stéfan A, Colin D, et al. Therapeutic education in persons with spinal cord injury: a review of the literature. Ann Phys Rehabil Med. 2011;54(3):189-210

[2] Feng Ye, Guo Jin, Mao Haijian, Zhu Yixi, Shu Tian, ​​Wang Yan, Zhai Hua*. Therapeutic effect and economic evaluation of rehabilitation intervention for workers with spinal cord injury at different stages[J]. Modern Medicine and Health, 2020, 36(17): 2667-2670.

[3]Sinden KE, Martin Ginis K A. Identifyingoccupational attributes of jobs performed after spinal cord injury: implications for vocational rehabilitation[J]. International Journal of Rehabilitation Research, 2013, 36(3):196-204.

[4]Gross-Hemmi MH, Fekete C, Post MWM, ScheelSailer A, Schwegler U, Brinkh of MWG. Detecting subgroups in social participation among individuals living with spinal cord injury: a longitudinal analysis of communitysurvey data. Spinal Cord. 2021;59(4):419-428.