Spinal cord injuries functional rehabilitation - Traditional approaches and new strategies in physiotherapy

Considering the body structures and systems loss of function, after a Spinal Cord Injury, with is respective activities limitations and social participation restriction, the rehabilitation process goals are to achieve the maximal functional independence and quality of life allowed by the clinical lesion. For this is necessary a rehabilitation period with a rehabilitation team, including the physiotherapist whose interventions will depend on factors such degree of completeness or incompleteness and patient clinical stage. Physiotherapy approach includes several procedures and techniques related with a traditional model or with the recent perspective of neuronal regeneration. Following a traditional model, the interventions in complete A and incomplete B lesions, is based on compensatory method of functional rehabilitation using the non affected muscles. In the incomplete C and D lesions, motor re-education below the lesion, using key points to facilitate normal and selective patterns of movement is preferable. In other way if the neuronal regeneration is possible with respective function improve; the physiotherapy approach goals are to maintain muscular trofism and improve the recruitment of motor units using intensive techniques. In both, there is no scientific evidence to support the procedures, exists a lack of investigation and most of the research are methodologically poor.