the goal of rehabilitation is reintegration into a community
through maximising the ability of the patient to be as independent
in mobility, self-care and independence as possible by facilitating
the function that remains whilst learning how to perform tasks
and activities differently when functions cannot return to pre-injury
levels whilst learning new methods. Spinal cord injury challenges
the choice of medical treatments and implementation of rehabilitation
programmes requiring frequent reviews through changing functional
goals over time and even change of environment. In addition,
rehabilitation aims to prevent negative consequences. Rehabilitation
can be initiated within a few days of the injury or, in some
cases, a few months after injury.
Studies have shown that successful reintegration into the community
provides an increased life satisfaction in terms of physical
independence, mobility, occupation and social interaction.
No two spinal cord injuries are alike and their impact on unique
individuals' means that treatments and therapies are specific
to the individual and they alter over time according to the individual's
changing needs and circumstances. Timing of an intervention is
important since the many dynamic underlying processes occurring
during the recovery phase of a spinal cord injury means that
the timing of the intervention, choice of the intervention, can
determine that intervention's likelihood of success.
In rehabilitation, many therapies attempt to improve specific
functional abilities or activities based upon the assumption
and agreement of the patient that those activities are a major
source of life satisfaction and increasing that activity leads
to an improved quality of life.
The quality of life satisfaction depends on the unique and personal
individual values of the patient. Life satisfaction after SCI
is associated with a better physical function, increased independence
and gainful employment. In addition, patients' global improvement
in quality of life is reported to increase with an early discharge
to their home and to be able to participate in meaningful leisure
activities including visiting friends and family as well as entertaining.
Patients desired greater community mobility and self-care independence.
An improvement and ease in nursing, mobilisation, physiotherapy,
pain relief, walking ability, seating position all help to provide
better comfort for the patient.
Intrathecal baclofen therapy is one such interventional therapy
that allows the multidisciplinary rehabilitation team, in appropriate
patients, to manage severe spasticity and spasms that may compromise
the patients' ability to fully improve their function allowing
the opportunity to realise better life satisfaction.
THERAPY: Age 18
HISTORY: Motorcycle accident in 1991 severed his spinal cord and left him paralyzed from the chest down. Jason experienced severe spasticity and spasms as a result of the SCI.
OUTCOME AFTER RECEIVING ITB THERAPY: Spasticity, spasms, and the related pain significantly reduced; hip dislocation that occurred before the therapy managed without hip fusion; sleep restored; transfers are no longer a problem; can sit in wheelchair all day; became physically active again.
COMMENT: “I've had no side effects, and I don't take any other medication for spasticity. None! I think of this pump as a tool, a tool that's made life a lot easier.”