Spinal cord injuries can be devastating to patients’ daily life and function. The extent of recovery depends greatly on the injury itself, and each patient’s trajectory after spinal cord injury is different. Although most patients recover as much as they will within the first three to six months following a spinal cord injury, recovery can carry on well beyond.
The trajectory of functional recovery from spinal cord injury tends to follow a certain pattern, although variations in these patterns exist from patient to patient 1. The first stage of recovery takes place immediately following a spinal cord injury. This will involve time at the hospital in a critical care department. A patient might also need to undergo surgery following their initial spinal cord injury. The second stage of recovery takes place outside of the clinic and focuses specifically on rehabilitation. This may include physical or occupational therapy. It may also include counselling to help support patients throughout the healing process.
During the first two years following a patient’s initial hospitalization, spinal cord injury-functional index scores tend to show small improvements. Substantial improvements are seen, however, in a small number of individuals with initially severe limitations in fine motor and self-care function 2.
Several factors impact recovery in various ways 3. First, the severity of a spinal cord injury plays a major role in recovery 4. The milder the spinal cord injury, the greater the potential for recovery. Second, the location of the spinal cord injury may also significantly impact recovery trajectory. Each of the 31 levels of the spinal cord receives sensory information and controls movement from different areas of the body. The higher the level of injury, the more functions are affected. Finally, secondary complications may interfere with a patient’s motivation and performance. If not properly managed, these are likely to negatively impact recovery.
There are a few ways in which recovery can be optimized. The early stabilization of a spinal cord injury is essential for minimizing any potential damage. The longer the spinal cord is compressed, the higher the likelihood of incurring lasting damage from secondary processes. Seeking immediate medical attention following a spinal cord injury can help patients significantly reduce overall damage to the spinal cord and reduce recovery time.
Rehabilitative therapy is also crucial for spinal cord injuries. Rehabilitation typically consists of physical and occupational therapy. In some cases, it may also involve speech therapy. Professionals will assess a patient’s functional abilities and create a personalized rehabilitation plan accordingly. Throughout the entire recovery period, consistent practice will help promote neuroplasticity and facilitate recovery. In addition, practicing any prescribed exercises and activities at home as required will also help speed up recovery.
One’s diet affects energy levels, mood, and body composition. These all impact motivation and performance over the entire period of spinal cord injury rehabilitation.
While there are some generalizations about the trajectory and timing spinal cord injury recovery, it is important for patients and clinicians alike to keep in mind that every patient ultimately experiences recovery slightly differently. Future studies should be focused on further exploring the personal, medical, and environmental characteristics that impact recovery trajectory during the first two years following a spinal cord injury and beyond. Additional patient-focused research will ensure the smoothest, safest recovery possible for patients across clinical contexts.
References
1. Spinal cord injury: Recovery, stages, and support. Available at: https://www.medicalnewstoday.com/articles/spinal-cord-injury-recovery. (Accessed: 23rd May 2023)
2. Tulsky, D. S. et al. Physical Function Recovery Trajectories After Spinal Cord Injury. Arch. Phys. Med. Rehabil. (2022). doi:10.1016/j.apmr.2021.09.012
3. Spinal Cord Injury Recovery Time: How to Speed Up Recovery. Available at: https://www.flintrehab.com/spinal-cord-injury-recovery-time/. (Accessed: 23rd May 2023)
4. Al-Habib, A. F. et al. Clinical Predictors of Recovery after Blunt Spinal Cord Trauma: Systematic Review. J. Neurotrauma 28, 1431 (2011). doi: 10.1089/neu.2009.1157