SPINAL CORD INJURIES

OUR METHODS

FSWC believes in intense exercise- based functional recovery in individuals with SCI and other neurological impairments like stroke and multiple sclerosis.

First Steps Wellness Centre is a specialized rehabilitation facility that was established to promote functional recovery among individuals with a spinal cord injury. Our methods differ from traditional rehabilitation as we focus on promoting functional gains below the level of injury through intensive exercise based recovery methods. Due to the success our clients with spinal cord injuries have had, we have made our methods available to individuals with other nervous system impairments such as Multiple Sclerosis, Stroke, Acquired/Traumatic Brain Injuries, Cerebral Palsy and Spina Bifida. We believe that each individual has a potential to recover lost function, the extent of which can depend on multiple factors: level of injury, Asia score, complete/incomplete injury, and experience with physical activity, etc.

We understand these factors and how these factors can be overwhelming. Each individual with an SCI is different and so are the sessions, which are customized to put our clients in positions where they will succeed and recognize their potential. We are proud to say that some of our clients have achieved the ability to walk after SCI and that all of our clients have achieved functional gain(s) below their level of injury which has directly increased their independence and overall quality of life.

Our methods are research-based and we follow the latest clinical best practices to produce outcomes that show functional recovery following a spinal cord injury. In recent years, more and more research is being done to understand the mechanisms leading to functional recovery after SCI.

Science Behind Our Methods

The spinal cord is a bundle of nerves that carries sensory, motor and reflex signals between the brain and the body. Injury to the spinal cord may interfere with the nerve conduction leading to sensory and motor impairments. As a result, individuals with a spinal cord injury (SCI) may not be able to perform activities in a way that is otherwise considered normal for that individual. This activity limitation challenges the individual’s participation in day-to-day life situations and activities. The ultimate aim of any physical rehabilitation program for an SCI should be to improve quality of life by improving function below the level of injury in each individual. Conventionally, physical rehabilitation has taken a compensatory approach. The belief that the nervous system is hard wired and irreparable has left clinicians and therapists with the option of training SCI’s to accommodate existing impairments and use assistive devices such as orthotics and wheelchairs to improve participation in day-to-day life situations and activities.

While the concept of functional recovery is growing in the rehabilitation industry, here at First Steps it is common for our clients to see increased function below the level of injury/lesion to their spinal cord. Denervation of the muscles below the level of lesion causes gradual deconditioning of the muscle resulting in structural changes such as decrease in muscle mass and number of muscle fibres (Biering-Sorensen et al., 2009). Depending on the level of injury, there may also be alterations in the tone of the muscles that may make movements difficult.

New research has shown there is a transformation from slow twitch fatigue resistant muscle fibers to fast twitch, fast fatiguing fibres. These physiological changes not only affect the functional capacity of the muscles, but also the metabolic functions of the muscles leading to metabolic disorders such as obesity, dyslipidemia and diabetes (Manns et al., 2005). Decrease in bone mass to a level of osteoporosis following an SCI is a common complication.

The bone mass below the level of lesion decreases rapidly after the first few years of injury and then continues to decrease gradually, unless addressed from the time of injury. Unloading is an important factor for osteoporosis along with neuronal and hormonal changes after SCI (Jiang et al., 2006). Compensatory approach not only discourages individuals with SCI to use residual function in the affected areas but also further weakens the affected areas below the level of lesion.

In recent years, there has been a shift in the way the concept of physical rehabilitation is viewed. Researchers have categorically stated that the field of modern neuro-rehabilitation no longer aims at compensation for disabilities; rather, it works through a spectrum of therapeutic interventions to gain functional recovery by use of “restorative neurology,” the practice of facilitating neural plasticity (Tansey, 2010). Physical activity is one such essential therapeutic intervention. Researchers have provided preliminary evidence to show that the nervous system is not hard-wired but malleable, and that function lost due to an SCI can be recovered. The evidence is particularly strong for walking recovery post SCI.

FSWC believes in intense-exercise based functional recovery in individuals with SCI and other neurological impairments like stroke and multiple sclerosis. Our exercise therapy sessions are based on principles of experience-based neuroplasticity which include high intensity, high repetitions and specificity of exercises. The FSWC method focuses on recognizing the potential of our clients and challenging them to improve their function.

FSWC has specialized equipment including; LiteGait® body weight supported gait trainer, FES (functional electrical stimulation) systems, Power Plate®, Keiser Rack®, Biodex Biosway®, Total Gym® and more to deliver such specialized services. Therapy sessions at FSWC include not just aerobic and strengthening exercises for physical conditioning, but also functional exercises to promote the relearning of developmental movement patterns.

Last but not the least, our qualified and trained staff along with our inspiring clients creates a positive environment ideal for recognizing the untapped potential in all of us to improve each day and overcome our limits.