Rehabilitation should begin in the acute stage of the injury. In the ICU and/or as soon as possible after the injury, range of motion and muscle strengthening exercises, respiratory rehabilitation, pressure reliefs, and proper positioning are necessary to prevent physical deterioration, such as contractures, pulmonary complications, and pressure sores, and the development of a helpless attitude in the patient. During the acute stage, the therapist should:

  • Focus on the muscles and joints that will be needed to achieve the best possible functional outcome
  • Adapt the rehabilitation program to the restrictions imposed by the medical and orthopedic treatments that are of paramount concern during this stage
  • Educate patients on their condition and foster a "can do" outlook
  • Encourage patients to assume responsibility for their care, perform as much of their care as possible, and seek assistance only when necessary

The PoinTIS SCI Physical Therapy site of the SCI Manual for Providers is based on information in Spinal Cord Injury: Functional Rehabilitation, by M.F. Somers, Norwalk, CT, Appleton & Lange, 1992, and information in "Respiratory Rehabilitation of the Patient with a Spinal Cord Injury", by J.L. Wetzel, B.R. Lunsford, M.J. Peterson, and S.E. Alvarez, Chapter 28 in Cardiopulmonary Physical Therapy, S. Irwin and J.S. Tecklin, eds., St. Louis, Mosby, 1995, unless otherwise indicated.