Choosing the right rehabilitation facility is one of the most important decisions a survivor of a brain or spinal cord injury will make. That’s because the type and quality of care will have a significant impact on the patient’s long-term outcome.

A good rehabilitation center should offer the survivor of a brain or spinal cord injury a combination of specialized medical care needed to return to the highest level of function, as well as the inspiration and strength needed to cope with difficult injuries.

Ranking the Facilities

Each year, US News & World Report ranks nearly 200 hospitals in 17 specialties. Included in this list is the top ten rehabilitation hospitals in the USA for the year 2007. Rankings are obtained through a nationwide survey of board-certified physicians. In order, this year’s top ten rehabilitation facilities are:
The Rehabilitation Center of Chicago in Illinois.
The Kessler Institute of Rehabilitation, with three locations throughout New Jersey.
The University of Washington Medical Center, Seattle, Washington.
Memorial Hermann-TIRR, Houston, Texas.
The Mayo Clinic’s Physical Medicine and Rehabilitation Center, Rochester, Minnesota.
Craig Hospital, Denver, Colorado
Rusk Institute, NYU Medical Center, New York, New York
Spaulding Rehabilitation Hospital, Boston, Massachusetts
National Rehabilitation Hospital, Washington, D.C.
Ohio State University Hospital, Columbus, Ohio.

Choosing a rehabilitation facility with an excellent track record of success, such as the ones listed above, will contribute to the success of the patient’s long-term outlook.

Q: What can you do immediately after an accident to minimize the long-term effects from a spinal cord injury (SCI)?

A: While there is still no way to completely reverse the damage done by a SCI, there are certain steps you can take to prevent further damage and to minimize the long-term effects.

After someone is discharged from the treatment facility, medical staff will focus on treating the initial injury, making sure it doesn’t develop into a worsening condition. Medications, immobilization and surgery will address the initial issues that arise from the accident, be it paraplegia or quadriplegia.

Once the patient is on his or her own, it becomes important to focus on the issues that can develop from being immobilized. Muscles will need to be stretched and maintained, bedsores watched for and treated and the urinary tract will have to be closely monitored to prevent infections. Paying attention to these aspects of care early on will help to prevent them from creating irreversible damage.

Rehabilitation therapy will be structured around the particular injuries each patient has suffered, and will attempt to help with the family and patient’s adjustment to their new situation. Sticking with the suggested program, exercises and all, is very important to the patient’s overall chance of recovery and regaining any degree of functioning.

During the difficult period after an injury is sustained, it is typically hard for people to maintain a positive and gung-ho attitude, but that the best chance to regain the ability to participate actively in life is to dive right into their rehabilitation program can’t be stressed enough.

Q: What should you look for when considering a SCI Rehabilitation Program?

A: There are a wide variety of rehabilitation programs, so finding the right one for your situation requires a comparison of your specific needs and what the center can offer you. Here are some useful questions to ask during your search:

Are the beds for people with SCI in the same area of the facility? Are there people in the SCI program of the same age and sex as the person considering admission?

Do the people in the SCI program have similar levels and kinds of spinal cord injury e.g., quadriplegia, paraplegia, incomplete and complete?

What is the average number of people admitted annually to the SCI program? (program staff should treat people with SCI on a regular basis to acquire and maintain expertise.)

Is the SCI program accredited by the Commission on the Accreditation of Rehabilitation Facilities (CARF) or theJoint Commission on Accreditation of Healthcare Organizations (JCAHO)? Has it been designated as a Model Spinal Cord Injury Center by the National

Institute of Disability Research and Rehabilitation (NIDRR)? Click here for a current list of Model spinal cord injury centers)
Is the SCI program part of a SCI rehabilitation system operated by the state?

Are there treatment specialists in the SCI program who speak the primary language of the individual seeking treatment?

Will the treatment team develop a rehabilitation plan with both short and long term goals?

Will an experienced case manager be assigned to help family members obtain medical payments and other benefits from public and private insurance? Will a team member be assigned to coordinate treatment and act as a contact for staff and family members?

Staffing/Rehabilitation Program Elements

Is the physician in charge a Physiatrist? If not, what credentials does he/she have? How long has the physician in charge been directing programs specializing in SCI? Is there physician coverage seven days a week? Twenty-four hours a day?

Do the regular nursing staff and other specialists responsible for providing treatment in the SCI program have specific training in treating SCI? Is the nursing staff employed by the hospital or employed through an outside agency?

Does the program ensure the availability of rehabilitation nursing and respiratory care on a twenty-four hour basis?

Are there consultants available at the facility or nearby medical centers? These should include neurosurgery, neurology, urology, orthopedics, plastic surgery, neuropsychology, internal medicine, gynecology, speech pathology, pulmonary medicine, general surgery and psychiatry.

How often and for how long each day will participants get treatment by specialists such as occupational and physical therapists? Treatment should be no less then three hours per day.

Are other specialties such as driver education, rehabilitation engineering, chaplaincy, and therapeutic recreation available if needed?

Are activities planned for SCI program participants on weekends and evenings?

How much time is spent teaching SCI program participants and their families about sexuality, bowel and bladder care, skin care and other essential self-care activities?

Does the SCI program offer training in the management and hiring of personal care assistants? If so, how much time is spent by staff on this topic?

Questions have been taken from Spinal Cord Injury Resource Center, a site created and maintained by a SCI patient who has drawn the previous questions from his own experience.

…or Tango, Hip-Hop…the choice in dance style is up to you, but the benefits are universal. In the Indian Spinal Injuries Centre (ISIC) they have started to use dance therapy, under doctor supervision, to help those with spinal cord injuries regain not only their physical health, but their mental wellbeing.

Deepti Aggarwal, the head of the lifestyle management department for the ISIC notes that while it may seem insensitive to ask a person regulated to a wheelchair to dance, the results are well worth the try. Aggarwal encourages the patients to use what motion is available to them - hands, fingers, shoulders. They are taught how to move their wheelchairs to the rhythm of the music and in turn experience increased confidence.

Hopefully this form of therapy will spread to the rest of the world as it has so many potential benefits to those who due to their injuries, until now have often felt cut off from pleasurable activities like dance.

Read the whole article here.

National Institute on Disability and Rehabilitation Research

The National Institute of Disability and Rehabilitation Research (NIDRR) is devoted to providing both leadership and support to all research related to the rehabilitation of people with disabilities. Located in Washington, D.C., NIDRR is part of the U.S. Department of Education, and works in conjunction with the Rehabilitation Services Administration (RSA) and the Office of Special Education Programs (OSEP).

NIDRR’s goals are two-fold: to help people with disabilities better live in their communities, and to expand society’s ability to provide full accommodations and opportunities to people with disabilities. NIDRR does research in the areas of social integration, employment, independent living, and technology, and is a key player in the growth in scientific knowledge such as rehabilitation medicine, engineering, psychosocial rehabilitation, integration, and vocational outcomes.

NIDRR also recommends a list of rehabilitation centers depending upon whether they meet certain stringent criteria.

NIDRR can be accessed through the U.S. Department of Education’s website, at www.ed.gov.