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The Ultimate Guide to Occupational Therapy for Spinal Cord Injury

Occupational Therapy for Spinal Cord Injury

Occupational therapy for spinal cord injury recovery helps you adjust back into everyday life.

Life after spinal cord injury can definitely get overwhelming, but occupational therapy will help teach you new ways to perform the same old tasks and be independent again.

This article will help you understand what to expect from occupational therapy for spinal cord injury and provide some tips for adjusting back to reality.

Occupational Therapy for Spinal Cord Injury

what to expect with occupational therapy after spinal cord injury

Every spinal cord injury will be a little bit different depending on its severity and location.

Those with cervical injuries will experience quadriplegia, which is when their arms and legs experience paralysis.

Those with thoracic, lumbar, or sacral spinal cord injuries will experience paraplegia, which is paralysis of the legs.

Both paraplegics and quadriplegics will need occupational therapy to get used to limited mobility.

The higher your level of injury, the more areas of your body will be affected by paralysis and the more dependent you’ll have to be on your caregiver.

The lower your level of injury, the more independent you can be and the easier it will be to perform daily activities.

Occupational Therapy vs Physical Therapy

Occupational therapy focuses more on developing your fine motor skills, which involve the smaller muscles used to do activities like writing or wiggling your toes.

In contrast, physical therapy focuses on gross motor skills, which involve the larger muscles necessary for movements like walking.

The two also vary in approach. An OT will focus more on the activity or occupation as a whole.

For example, if a patient has trouble reaching for a bag of chips, an occupational therapist will think of the task and ask: “what can the patient do to make reaching for a bag of chips easier?”

On the other hand, a physical therapist thinks about the underlying movement and asks: “how can the patient develop the arm muscles necessary to reach?”

Physical therapy will focus more on developing your gait, strength, flexibility, and endurance while occupational therapy focuses more on developing your ability to perform activities of daily living.

Activities of Daily Living

There are 6 activities of daily living that your occupational therapist will help you adjust to after spinal cord injury.

1. Eating

adapted utensils for SCI recovery

If your spinal cord injury results in paraplegia, you should have no problems eating.

However, if your spinal cord injury results in quadriplegia, you’ll experience difficulties using your arms, which makes it difficult to use utensils and get food into your mouth without making a mess.

Your occupational therapist will probably have you utilize adapted utensils and plate guards to help make eating after spinal cord injury easier.

Adapted utensils can wrap about your arm or bend so that your grip and dexterity don’t necessarily have to be so great to pick up food.

A plate guard will help keep food on your plate for those that don’t have the wrist function to scoop it up.

While an occupational therapist may suggest alternative tools for you to perform activities, the main goal is to not have to use them.

Your occupational therapist will likely have you perform hand exercises so that you can develop the fine motor skills necessary to use regular utensils.

For example, you may need to use adapted utensils at the beginning of your recovery, but the more you use them, the better you get at gripping the handle and moving your wrist.

The great thing about adapted utensils is that they usually can be adjusted for various levels of recovery. You can slowly start wrapping the handle less tightly around your arm or change the angle that the fork is bent so that you’re forcing your muscles to engage more with the action.

2. Bathing

bathing ot for sci

Bathing after spinal cord injury can be difficult for both paraplegics and quadriplegics.

Sponge bathing may be a convenient option for those who have very limited mobility.

For the most part, paraplegics will be able to bathe themselves. Those with thoracic spinal cord injuries may experience difficulties balancing and will need to install grab-bars in the bathtub to hold onto.

The bathroom is one of the most dangerous rooms in a home because floors can get extra slippery. Be sure to have bathmats inside and outside of the bathtub to reduce falls.

Quadriplegics will most likely need the help of a caregiver for bathing, but tools like a long handle back sponge can help them reach more areas.

3. Dressing

Putting on your pants while you’re still in bed can help make them easier to slide on than if you were to be sitting in a wheelchair.

We recommend that you wear comfortable, loose-fitting clothing because those are the easiest to put on. Rough or textured clothing can irritate the skin.

Wearing clothes that are too tight can cause autonomic dysreflexia, which is when your blood pressure spikes.

4. Toileting

After a spinal cord injury, you may experience neurogenic bladder or bowel and be unable sense when you need to use the restroom.

To prevent accidents, make sure that you’re going to the bathroom regularly, using a catheter, or following a bowel program.

Grab bars will help stabilize you as you transfer or lift yourself, raised toilet seats allow you to bend down less as you get seated, and wiping aids will help those who have trouble reaching and wiping.

5. Transferring

transfer bench adaptive equipment for spinal cord injury patients

It’s necessary to learn how to get on and off your wheelchair so that you can get onto your bed, bathtub, or toilet easily.

Setting up transfer benches in the bathtub and grab-bars to hold onto for balance will help make it easier to transfer from your wheelchair onto other surfaces.

Make sure that the brakes of your wheelchair are always on before any transfer.

6. Mobility

learning how to use wheelchair at occupational therapy for spinal cord injury

Your occupational therapist will also teach you how to move around in a wheelchair.

You’ll learn to depend heavily on your arms to make up for lack of leg function.

Those with cervical injuries that don’t have enough arm function will need to use a power wheelchair.

Those with less severe paralysis of their legs may only need to use a walker.

Getting Back to Work or School After Spinal Cord Injury

work after spinal cord injury

Occupational therapy should also prepare you to go back to work or school.

Your occupational therapist should work with you and your employers to ensure that the work environment is wheelchair accessible and safe.

This involves making sure that there’s enough space for your wheelchair to get through and that there are wheelchair-friendly alternatives to stairs.

For those that are going back to school, your OT should ensure that you can get around campus without difficulty.

It’s a good idea to familiarize yourself with where the elevators and ramps are in each building to save time.

Getting Back on the Road After Spinal Cord Injury

driving occupational therapy for sci

Believe it or not, you may even be able to drive again after a spinal cord injury.

Check if your rehabilitation center has a driving program. If not, you can find one at the Association for Driver Rehabilitation Specialists.

You’ll undergo evaluations to ensure that you can safely drive and your certified driver rehabilitation specialist will help you get the car adaptations you need to get on the road again.

Driving after spinal cord injury allows for a whole new level of independence.

Occupational Therapy for Spinal Cord Injury Over Time

occupational therapy for spinal cord injury helps patients transition back to day-to-day life

As you recover,  you’ll develop your preferences and change the way you perform these tasks.

Try not to use adaptive tools if you don’t need them. You want to challenge your body to move as much as possible.

Your body’s a lot smarter than you think and the more you repeat a movement, the easier it gets to perform.

Occupational therapy for spinal cord injury makes a huge difference in terms of recovery and teaches you valuable tips and tricks for adjusting back to everyday life.

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