New rehabilitation research demonstrates functional improvements in patients with spinal cord injuries

Sue Ann Sisto, PT, MA, PhD, Professor of Physical Therapy, Research Director, Division of Rehabilitation Sciences, Director of the Rehabilitation Research and Movement Performance (RRAMP) Laboratory, Stony Brook University School of Health Technology and Management (SHTM), and Co-Director of the Christopher & Dana Reeve Foundation NeuroRecovery Network (NRN), says the findings suggest that a shift in both protocol and policy is needed at rehabilitation centers across the nation to advance and standardize rehabilitation care for patients with spinal cord injuries.

"These studies provide scientific and clinical evidence from hundreds of patients that long-term rehabilitation practices such as locomotor training, exercise, and wellness activities for patients with full or partial spinal cord injuries lead to improved health and function in patients," summarized Dr. Sisto, a co-author on several of the 11 studies published in Archives.

While a majority of the studies evaluate activity-based rehabilitative practices involving the assessment and improvement of patients' motor or neurological functioning, other studies evaluate patients' overall health status. For example, in "Cardiovascular Status of Individuals with Incomplete Spinal Cord Injury from 7 NeuroRecovery Network Rehabilitation Centers," researchers concluded that a patient's resting blood pressure and heart rate are affected by body position, age, and neurological level. They also found that more than one-fifth of patients had a quick drop in blood pressure with a sudden position change from lying to sitting.

Dr. Sisto, lead author of the cardiovascular status study, points out that the overall findings provide a reference for cardiovascular health parameters for individuals with incomplete spinal cord injuries. The study, she adds, also provides clinical evidence that rehabilitation centers should consider clinical screening for cardiovascular dysfunction in patients.

All of the studies featured in the Archives issue involve reporting of outcomes from seven NRN rehabilitation centers around the country. Established and funded by the Christopher & Dana Reeve Foundation, in cooperation with the Centers for Disease Control and Prevention, NRN centers translate scientific advances into activity-based rehabilitation treatment for individuals with spinal cord injuries.

Dr. Sisto says that practices like locomotor training, which consists of activities involving step training using body support on a treadmill, and with manual assistance, are valuable and show great promise for motor improvement in chronic spinal cord injury patients. New computer and other technologies, she says, are also helping to improve physical therapy and rehabilitation practices for patients, as well as help professionals more effectively chart patient progress.

Locomotor training and other rehabilitation practices are used at Stony Brook's RRAMP laboratory, a state-of-the-art research center within the SHTM. The laboratory is dedicated to studies of rehabilitation interventions that enhance the recovery process of those living with paralysis or spinal cord injuries, or suffer from debilitating illnesses that affect mobility.

Earlier in 2012, the SHTM announced its collaboration with Los Angeles-based NextStep Fitness with the intention to build the organization's first fitness and wellness facility in New York State for people with paralysis and spinal cord injuries. Plans are underway to construct the new rehabilitation, fitness and wellness facility in a free standing building that will be adjacent to the RRAMP Laboratory.