Most people who have had a significant SCI injury will require long-term rehabilitation. They may need to relearn many or all basic skills. The goal is to improve their abilities to perform daily activities.

Therapy usually begins in the hospital and continues at an inpatient rehabilitation unit, a residential treatment facility or through outpatient services. The type and duration of rehabilitation varies by individual, depending on the severity of the SCI and what part of the spine was injured.

Ambulation is a crucial component to recovery and lifetime health. Movement keeps joints lubricated and stimulates the survivor’s brain, encouraging brain plasticity repair. Stronger muscles and bones provide the strength and balance the SCI survivor needs to be active.

Physical therapy programs should be designed to help with mobility and relearning movement patterns, balance and how to stand and walk again. SCI survivors may need to go slowly.

Walking ability has important health implications, providing protective effects against secondary long-term complications after SCI, including respiratory, cardiovascular and urinary and bowel complications; spasticity; pain syndromes; pressure ulcers; osteoporosis and bone fractures.

SCI can exacerbate the physical and physiologic declines brought on by the aging process. Many long-term follow-up studies and authors have documented the tendency for individuals with SCI to age faster than the able-bodied population does.

While SCI survivors heal and progress at different rates, virtually all survivors can relearn to improve health by practicing standing and walking again. Even if someone has been primarily wheelchair or bed-bound for years (with little intervention), they can achieve significant results and greater quality of life with the proper program, and with proper equipment.

Many of our GHS clients see consistent standing and walking progress in the years and life span of SCI recovery.

By necessity, early gait intervention comes second to the other complications and concerns of a healing body.

A recent study at Cleveland Clinic found that patients participating in early mobility routines after neurological injury recovered quicker and went home earlier than those receiving standard care.

There is growing evidence showing the provision of early ambulation support to critically ill and injured patients result in more favorable recovery outcomes as compared to less aggressive approaches.

The magnitude of bone lost in the lower limbs following SCI is substantial. Early weight-bearing after acute SCI by standing or treadmill walking (5 times weekly for 25 weeks) resulted in no loss or only moderate loss in trabecular bone compared with immobilized subjects. 6 weeks after SCI, there begins a rapid and dramatic loss of muscle mass below the level of the lesion.

Early rehabilitation is important to prevent disability and complications. Literature shows that the best time for starting independent gait recovery for an incomplete SCI occurs as soon as it is safe to do so, once the survivor is medically stable, hopefully within the months after injury. The sooner muscles start working again after SCI, the better the chances are of additional recovery-especially for standing and walking again.

Initially, a therapist practitioner may start the SCI survivor with passive standing (and consider use of long leg bracing and FES). Passive standing is a relatively easy physical activity that may reduce the risk of secondary medical complications after SCI, such as pressure ulcers and has been shown to improve the perception of well-being in those with SCI.

Standing has been shown to counteract many of the effects of chronic immobilization and spinal cord injury, including bone demineralization, urinary calculi, cardiovascular instability, and reduced joint range of motion and muscular tone. Standing has been used as a treatment for spasticity as well as an intervention to prevent contractures and reduce bone loss in SCI.

Over-ground therapy is more effective than robotic BWSTT

Over-ground walking is an effective means to regain greater independence of gait. The Gait Harness System provides a secure, comfortable, safe environment for the SCI client to practice functional standing and walking again.

Body weight support treadmill training (BWSTT), which relies on total guidance of robotics, leaves little room for active effort on the part of the client, a key aspect in motor learning and functional gains.

Research shows that for most participants, BWSTT is not sufficient to induce long-term improvements in balance and balance confidence.

Comparing over-ground training to the robotic treadmill training suggests that it is not the length of time spent in training, but rather how an individual engages in the activity that produces the results. Or, that a greater number of step repetitions produces greater functional change in walking ability, but only when transferring the skill to a natural walking environment.

Studies also show that walking on a treadmill does not carry over well to over-ground walking. The active motor requirements in over-ground walking appear to be an important factor for promoting spatial symmetry in gait.

Compared to BWSTT, a recent study showed that step-length symmetry ratio improved only with the over-ground therapy gait group. Reduced step length symmetry ratio has been found to increase fall risk. Improving step length symmetry through over-ground gait training has the potential to decrease fall risk.

Improving gait symmetry through over-ground practice, in the “real world,” contributes to a goal of more “normal” walking patterns.

The Second Step GHS encourages client-centered, supported, faster walking and more functional, natural movement. The System provides a novel, optimal gait training strategy for SCI survivors, enabling goal-directed recovery and maintenance of walking ability.

Research shows that SCI recovery is boosted by longer and more intense rehabilitation. Care and treatment for SCI may be required across the life span.

Research proves the effectiveness and importance of aggressive inpatient rehabilitation following spinal cord injury. Evidence based practice also proves the importance of intensive, aggressive outpatient rehab on a long-term basis.

How do SCI survivors move beyond the obstacles of learning to stand and walk again? Through caregiver and practitioner support, sheer determination, and a mindset of never giving up, no matter how long it takes: repetition, intensity, and practice.

Studies show a daily commitment to standing and walking therapy practice (or ideally multiple therapy sessions daily) yields the best outcomes.

GHS Standing & Walking Frame equipment can help

Non-pharmacological treatment methods such as standing-up, orthotically aided walking, weight – bearing physical exercises, functional electrical stimulation and pulsed electromagnetic fields have been studied in the literature. In various studies standing-up and orthotically-aided walking seem to have a favorable effect during the early phase of SCI.

Evidence based practice also confirms that ambulation spanning the long-term SCI recovery phases using an over-ground, all-in-one standing frame and walking frame support system, such as the Gait Harness System, should be encouraged.

The SCI survivor may begin using the GHS as a body weight supported, passive standing frame, then move on to ambulation via walking frame support when they are ready to do so. Functional recovery progress thus can be made for the years to come.