Spinal Cord Injury Rehabilitation
With expert rehabilitative care, spinal cord injury patients can return to active, productive, fulfilling lives. We see it happen every day. The Spinal Cord Injury (SCI) programs of the Spaulding Rehabilitation Network provide an unparalleled level of care and support for individuals recovering from spinal cord injuries.
We treat patients who have suffered a spinal cord injury as a result of traumatic injury or illnesses. Our comprehensive rehabilitation program focuses on maximizing neurological recovery while helping patients develop strategies for independent living. We do this in a comfortable, supportive environment in which patients – with the help and support of their families – can attain the skills they need to return to their community.
We are able to treat the entire spectrum of spinal cord injuries, from inpatient rehabilitation at several different levels of care depending on each patient’s medical and rehabilitation needs, through outpatient therapy and community reentry.
In Boston, we offer an SCI Ventilator Program for patients requiring mechanical ventilation as a result of their injury. The focus of the program is on ventilator weaning while engaging the patient in education and therapy. Spaulding Rehabilitation Hospital Boston is the first rehabilitation hospital in New England to use the Synapse Diaphragmatic Pacing System (DPS) to facilitate weaning for ventilator-dependent SCI patients.
Approach to Care
The goals of the Spinal Cord Injury program are to ensure optimal physical, emotional and social adjustment following a spinal cord injury, to maximize functional independence, and to improve quality of life.
At the Spaulding Network, patients learn the foundational skills for independent living by assuming greater responsibility to direct and perform their own care. It’s a challenging process, one that can be both physically and emotionally trying. With the support and guidance of our caring and knowledgeable staff, patients can make remarkable strides, growing steadily stronger and more confident.
Family members are also important participants in each patient’s rehabilitation team. We offer training and education to help them play an active support role while their loved one is in the hospital and after he or she returns home.
Expertise
Our clinical teams draw on the most advanced research on spinal cord injury rehabilitation techniques, and have immediate access to the equipment, technology and specialists of the entire Spaulding network.
Our interdisciplinary teams include physicians and nurses, physical, occupational, speech and respiratory therapists, nutritionists, therapeutic recreation specialists, psychologists, case managers, social workers, and vocational rehabilitation counselors. Specialized physician consultants are available through the Partners HealthCare system. In addition, we partner with the Greater Boston Chapter of the National Spinal Cord Injury Association to provide peer visitation so patients can learn from others who are living successfully with spinal cord injury.
A Comprehensive educational series is provided for patients, families and caregivers that maximizes the understanding of their injury. One-on-one education and training is also provided for patients and families so they are confident and successful in the community. The therapeutic environment is active and optimistic. To assist in the patient’s adjustment, we provide inpatient and community based support groups that enhance the sense of well-being and accomplishment. Our adaptive sports programs provide patients with unique recreational opportunities.
Following discharge from the inpatient setting, a plan is given to the patient for ongoing therapy and services. The Spaulding Network provides long-term follow-up by physicians who are board certified in physiatry and spinal cord injury medicine. The clinical team is familiar with resources throughout New England so the patient can continue to be successful if services are provided closer to home.
Program Outcomes/Success Rates
In 2010, SCI patients at Spaulding Rehabilitation Hospital Boston achieved higher functional gains than the national average.
Program Director(s)
Dr. Kevin O’Connor is the Medical Director for the Spinal Cord Injury program at Spaulding Rehabilitation Hospital Boston. He is board certified in Physiatry as well as Spinal Cord Injury Medicine. His career focus has been on improving the lives of those with a spinal cord injury.
Research & Innovation
The Spaulding Network is committed to rehabilitation research to find best practices and opportunities to improve the lives of those with paralysis resulting from spinal cord injury. Our efforts not only focus on researching new rehabilitation strategies but also look at ways to prevent long-term complications related to paralysis.
Under the leadership of Dr. Ross Zafonte, Vice President for Medical Affairs in the Spaulding Network and internationally known for his research expertise, several Research studies are currently underway for SCI including:
Research Program
Spinal Cord Injury Model Systems (SCIMS) Program
Description
This is a multicenter program allowing Spaulding clinicians and researchers to improve both regional and national understanding of SCI treatment models. Each SCI Model Systems site contributes to the national SCI Model Systems Database for a better understanding of long-term health outcomes.
Research Program
Outcomes of Individuals with Both Spinal Cord Injury and Traumatic Brain Injury
Description
This is a multicenter study using both the TBI Model Systems and the SCI Model Systems databases. Spaulding, under the guidance of Dr. Mel Glenn is now in the data analysis phase.
Research Program
Effectiveness and Generalizability of Hybrid-FES Exercise for Physiologic Declines in Spinal Cord Injury
Description
The purpose of this research project is to determine the effectiveness and generalizability of an unique aerobic exercise paradigm (hybrid FES-rowing) as an intervention to promote improved health and function in individuals with chronic SCI and to explore this form of exercise as a prevention for the declines that occur within the first years after acute SCI. Our primary outcomes relate to exercise capacity and cardiovascular risk, however given the range of effects exercise can have, we are examining secondary measures of bone density, pulmonary function, psychological affect, social integration, and clinical status.
Research Program
The Spaulding ExPD Program – FES-row Training for SCI
Description
Spaulding’s ExPD program’s mission is to provide appropriate exercise to improve health in those with physical disability. We focus on FES rowing for those with SCI, which requires a level of performance comparable to the able-bodied and can be integrated into currently existing communities of able-bodied rowers and therefore may be an optimal exercise intervention for the SCI population.
Research Program
Investigation of the Mechanisms of Transcranial Direct Current Stimulation of Motor Cortex for the Treatment of Chronic Pain in Spinal Cord Injury
Description
Dr. Felipe Fregni and his team are investigating the effects of transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, on chronic central pain in spinal cord injury. We are also using electroencephalography (EEG) and transcranial magnetic stimulation (TMS) to measure changes in the brain, both before and after tDCS. Our primary aim is to see if using tDCS stimulation can help reduce the chronic central pain associated with spinal cord injury.
Research Program
Investigation of the Mechanisms of Transcranial Direct Stimulation of Motor Cortex Coupled with Visual Illusion for the Treatment of Pain in Spinal Cord Injury
Description
Under the leadership of Dr. Felipe Fregni, Spaulding is investigating the effects of transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, combined with watching a visual illusion on chronic central pain associated with spinal cord injury. During tDCS stimulation, the participant watches a "visual illusion." The participant will see a video of walking legs on a treadmill, and their torso reflection in a mirror. They are asked to imagine themselves walking while they are watching the illusion. We are also using electroencephalography (EEG) and transcranial magnetic stimulation (TMS) to measure changes in the brain, both before and after tDCS. Our primary aim is to see if using a visual illusion combined with the tDCS stimulation can help reduce the chronic central pain associated with spinal cord injury.
Research Program
Adiposity and Bone Loss in Spinal Cord Injury
Description
The goals of this project are to determine the degree of bone formation, bone resorption, and rate of bone loss longitudinally at the distal femur and proximal tibia in subjects with chronic SCI with varying degrees of neurologic impairment and in able-bodied subjects, and to determine the relationship between regional fat distribution assessed directly from DXA scan data and longitudinal change in BMD at the distal femur and proximal tibia, and assess the relationship between circulating levels of adipose derived hormones (leptin and adiponectin) with bone loss at the distal femur and proximal tibia.
Research Program
Longitudinal Assessment of Fracture Risk in Spinal Cord Injury
Description
The goals of this project are to compare the effect of FES-row training alone versus FES-rowing plus Zoledronic Acid on bone density of the paralyzed lower extremity and to compare the effect of FES-row training alone versus FES-rowing plus Zoledronic Acid on bone micro architecture of the paralyzed lower extremity.
Research Program
FES-Rowing versus Zoledronic Acid to Improve Bone Health in SCI: A Comparative Clinical Trial
Description
The project, which is funded by the Department of Defense, aims to compare the effect of FES-row training alone versus FES-rowing plus Zoledronic Acid on bone density of the paralyzed lower extremity and to compare the effect of FES-row training alone versus FES-rowing plus Zoledronic Acid on bone micro architecture of the paralyzed lower extremity.
Locations
The Spaulding Rehabilitation Network provides a full spectrum of rehabilitation care for SCI including Acute Rehabilitation Hospitals, Long Term Care Hospitals, and Skilled Nursing Facilities. Depending upon the individual circumstances and the level of care needed for the patient, one of the following Spaulding facilities may be recommended:
Inpatient
Spaulding Rehabilitation Hospital Boston
Spaulding Rehabilitation Hospital Cape Cod
Spaulding Hospital for Continuing Medical Care Cambridge
Spaulding Hospital for Continuing Medical Care North Shore
Spaulding Nursing and Therapy Center West Roxbury
Spaulding Nursing and Therapy Center North End
Related Services
The following services are related to the Spinal Cord Injury Rehabilitation Program at Spaulding.
Adaptive Sports
Armeo
Assistive Technology (ATEC)/ Alternative and Augmentative Communication (ACC)
Bioness
Brace Clinic/Prosthetics Clinic
Erigo
Exercise for Persons with Disability (ExPD)
Lokomat
Pressure Mapping Systems
Wheelchair/Seating Clinic
Interactive Location Map
