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In spinal cord injury, the connection between the brain and body is lost — the brain can no longer tell the body to move, and the neural cells no longer have the patterned activity they need to grow and differentiate. Activity Based Restorative Therapies (ABRT), under the direction of physicians and therapists, help patients with spinal cord injuries perform activities that prompt remaining cells to “remember” how to move while encouraging the growth of new nervous system cells.
In ICSCI's innovative rehabilitation program, individuals with paralysis gain improved health and quality of life — and most recover some degree of sensation, movement, and independence.
Activity Based Restorative Therapies:
ABRT establish normal patterns of activation in the nervous system and can encourage neural regeneration. These therapies also help patients avoid complications of paralysis such as osteoporosis, skin breakdown, infection, cardiovascular decline, and other signs of premature aging, which are costly to treat and detrimental to overall quality of life.
Cycling with Functional Electrical Stimulation (FES)
FES works by having a computer send electrical messages to a person’s muscle, causing it to contract in a way that can be used for purposeful movement, such as grasping an object. Riding an FES bike simulates the physical activity that a person normally experiences during an average day. Cycling for one hour is equivalent to walking 6,000 steps.
The buoyant force of water supports about 90 percent of a person’s weight and provides a unique therapeutic environment. People with paralysis can perform activities in water that would be impossible for them on land. This therapy, like cycling an FES bike, can provide the patterned stimulation needed to promote the growth of neural cells.
Partial Weight Supported Walking (PWSW)
Partial Weight Supported Walking therapy involves suspending patients in a harness and allowing them to walk over an electric treadmill at a very low speed. For individuals unable to initiate stepping, two therapists will help advance the lower extremities and ensure an efficient and technically correct gait pattern. Gait training allows a person to relearn natural walking while recovering mobility. As gait pattern is established, the individual is allowed to bear progressively more weight through the lower extremities. In the case of incomplete spinal cord injury, the PWSW is followed/complemented by traditional over-ground walking.
Our patients also spend therapy time working on strengthening the core muscles of the trunk and abdomen, which they need to sit and stand. Time is also spent on standing activities in preparation for more patterned activity that simulates walking. We make use of the latest equipment available.
What to Expect:
A physician and therapy team evaluate a patient's medical history and conduct a thorough physical examination prior to the first therapeutic session. The results are used to adapt therapy to an individual's capabilities. Regular revaluations occur throughout the process to ensure continued safety and effectiveness.
Therapy sessions, which typically last from three to four hours, are conducted on an individual basis and focus on the achievement of goals established between patient and physician. Typical treatment focuses on the muscles required for sitting, standing, and walking. Gains in these muscle groups lead not only to improvements in overall health but to increased independence in the performance of activities of daily living (ADL).
We offer ABRT, physical, and occupational therapy as well as a number of services to detect and treat conditions common to people with paralysis.
- Bone density measurements by DXA scans to prevent, detect, and treat osteoporosis
- Urodynamic studies are available to adult patients
- Review of seating and seating recommendations, including pressure mapping as needed
- Nurses are available for consultation about skin issues and bowel and bladder management
- Ongoing monitoring by our nursing staff
- Occupational therapy to assist patients in returning to activities of daily living and instrumental activities such as vocational and leisure activities
- Physical therapy to improve or recover physical strength and abilities
- Innovative ABRT
- Nurse case managers are available to provide information and general assistance
Long-term Treatment Options
For patients who live in or near Baltimore and are able to routinely attend our facilities, we recommend ongoing sessions several times per week.
For patients who find this impractical, the Center has designed a therapy concept for home use. Patients will need to visit the center for at least two weeks of short-term daily therapy. The International Center for Spinal Cord Injury will provide -- either for use at home or with a local therapist -- a customized treatment program. Patients are encouraged to return on a regular basis to update their personalized program.
Although we provide prescriptions for items you will need to succeed in your therapy, we have found some insurance companies are reluctant to cover these expenses. We work closely with your local providers and have a Financial Counselor available to discuss insurance benefits with you.