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Madonna Rehabilitation Hospitals

Spinal Cord Injury

Our CARF-accredited spinal cord injury rehabilitation program is sought after by SCI survivors from across the nation. 

Technology, expertise and a commitment to teaching are among the features that make Madonna's spinal cord injury program unique and effective, regardless of the level of injury. 

Family members are encouraged to participate in therapy sessions whenever possible. Madonna team members are committed to educating patients and family so they feel confident in care moving forward. 

Technology can help with repetition and simulation of real-world activities, as well as providing adaptations for returning to work and recreational activities after a spinal cord injury. 

Program medical director Paul Krabbenhoft, MD has a personal connection to spinal cord patients. 

Our intensive and highly individualized therapy program helps spinal cord injury patients regain their maximum level of independence. 

Patient Stories

Spinal Cord Injury Rehabilitation

Patients will be seen daily by a physiatrist, also known as a Physical Medicine and Rehabilitation (PM&R) physician, who specializes in the rehabilitative treatment and management of disease and injury affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons. The primary focus is to restore function and promote overall health.

Registered nurses with rehabilitation training or experience are on staff at all times to care for patients.

Madonna provides a comprehensive continuum of care for our spinal cord patients, regardless of severity.

Madonna is unique in that we have two licensed hospitals located in Omaha and Lincoln. Our specialty hospitals (commonly known as LTCH, or long term acute care) are overseen by internal medicine hospitalists,  providing complex medical care for patients with a broad range of needs. Our approach to complex medical care enables patients to participate in rehabilitation from their first days at Madonna. The therapy process is customized to each patient based on their diagnosis and abilities, but the goal at this level is to help the patient tolerate increased activity while building up their endurance and strength to either return home or move to the rehabilitation hospital.

Our acute rehabilitation hospitals provide an intense program by providing of three or more hours of therapy per day. By focusing on community reintegration and getting patients ready to resume their life activities, the goal at the acute care level is to resume the highest level of independence possible. Having both levels of care on the same campus minimizes the need for transfer and provides continuity and enables collaboration among clinical teams.

Our Rehabilitation Day Program (RDP) may be appropriate at the next stage. Patients return to our campus 2-5 times per week for several daily hours of therapy, split among multiple disciplines of occupational, speech and physical therapy. RDP allows for community reintegration while still benefiting from a rigorous therapy schedule.

Outpatient therapy is offered through Madonna’s TherapyPlus clinics. Frequency of therapy is unique to each patient. Outpatient therapy can include one or more discipline and vary in frequency depending on patient needs.

Madonna staffs licensed respiratory care practitioners at all times. Our respiratory therapists are able to provide arterial blood gas (ABG) services, ventilator management and weaning as well as tracheostomy management and weaning. Madonna is recognized as a Center of Excellence for Vapotherm and the Passy-Muir valve, specialized technology utilized for patients with tracheostomy tubes.

Patient-family education is provided on a wide variety of topics, including emergency preparedness, management of a personal assistant, aging with disability, prevention of potential risks and complications from SCI, life-care planning, self-advocacy and community resources.

Madonna provides a full range of inpatient pharmacy services, including medication distribution, patient education, and clinical/dosing services.

Madonna is able to provide radiology services that include X-ray, ultrasound, echocardiogram, venous doppler, arterial doppler, Holter monitor,  and electroencephalogram (EEG).

Madonna's in-house laboratory provides anticoagulation, hematology, chemistry, therapeutic drug level testing and urine analysis services with results available the same day in most cases.

Madonna has registered dietitians and licensed medical nutrition therapists who are part of the care team and ensure the patient's individualized nutrition plan is met

Neuropsychologists and rehabilitation counselors are an integral part of rehabilitation at Madonna.  They provide a variety of services, including neuropsychological assessment, adjustment counseling, pain management, family therapy, concussion or mild brain injury evaluation, memory testing, dementia evaluation, neurofeedback, biofeedback, behavioral management and psychoeducation

Assistive Technology Professional certified therapists provide seating and positioning evaluations for patients who use a wheelchair.

Our Spinal Cord Injury Program is comprehensive, providing medical interventions in the areas of autonomic dysreflexia, bladder and bowel function, circulation, swallowing and nutrition, infection, medication management, musculoskeletal and neurological effects, pain, respiration including ventilator and/or tracheostomy management, sexual function/fertility, skin integrity and spasticity management. Patients with a need for chemical use/abuse/dependency treatment are referred for treatment outside Madonna.

Life-long wellness training — including having a plan to stay active and to exercise safely — is also important for individuals completing their rehabilitation. Our trained staff promotes success by employing specially adapted equipment to teach patients how and what to do in a community based fitness environment. In addition, they explore new wellness opportunities that match a patient’s current fitness level.

Madonna is committed to meet all the needs of its patients--physical, spiritual and emotional. A spiritual care professional is a member of and consults with the care team. The chapel, the heart and soul of Madonna, is there to nurture faith and hope during times of crisis.

Madonna's Continence Specialty Program helps patients who, because of an illness or serious injury, experience bowel and bladder dysfunction symptoms regain control and return to their life roles.

Madonna has been a ThinkFirst Chapter since August 2010, creating injury prevention awareness in the community. We are committed to promoting safety and our clinicians offer expertise at thousands of community events each year to reduce the risk of serious injury. 

Madonna is committed to the lifelong success and wellness of our patients. When appropriate, we offer services such as home modifications, assistive technology, orthotics, prosthetics and emotional support resources for patients during and after their preparation to return home. 

Rehabilitation after spinal cord injury is not just about regaining basic skills of self-care and mobility. The ability to resume one’s life role and reintegrate back into the community is an important component. Madonna integrates a variety of community re-entry, recreational, leisure and adaptive sports and recreation opportunities into the rehabilitation process. Therapy may include off-site visits to locations that may be challenging for spinal cord injury patients. Patients may also work on specific goals related to returning to work, school or driving during their rehabilitation stay.

Madonna’s spinal cord injury patients and their caregivers are provided with a self-care training program based upon principles of self-advocacy and self-direction. Patients are taught how to direct their care and what to do if emergencies arise. They are provided opportunities to practice these skills during their stay, ending with a two-night stay in Madonna’s transitional living apartment. This apartment is located on the unit, with easy access to medical staff if needed, with the expectation that a family member or caregiver will assist with personal care required during their stay. The patient will direct his or her care and independently follow a therapy schedule.

Madonna’s Spinal Cord Injury Rehabilitation Program serves children 0-18 and adults of all ages with any level of complete or incomplete neurological impairments as a result of traumatic or non-traumatic spinal cord injury (SCI). An interdisciplinary team of clinicians address a multitude of functional areas, including activities of daily living (ADL), assistive technology, behavior management, cognition (thinking and reasoning skills), communication, community integration, driving, durable medical equipment, environmental modifications, leisure and recreation, mobility, orthotics and prosthetics, wheelchair seating systems and vocational rehabilitation.

Patient-family education is provided on a wide variety of topics both one-on-one and in a group classroom setting.  Education classes address emergency preparedness, management of personal care assistants, aging with disability, prevention of potential risks and secondary health complications from SCI, life-care planning, self-advocacy and community resources. This education is also available to the community and other professionals and provided through webinars, prevention education events, continuing education events and mentoring. 

The program is comprehensive, providing medical interventions and assessment in the areas of co-morbidities, neurological changes, abnormal tone, body composition, autonomic dysreflexia, bladder and bowel function, circulation, swallowing and nutrition, infection, medication management, musculoskeletal and neurological effects, pain, respiration including ventilator and/or tracheostomy management, sexual function/fertility, skin care and spasticity management. Patients with a need for chemical use/abuse/dependency treatment are referred for treatment outside Madonna.

Health promotion and life-long wellness training — including having a plan to stay active and to exercise safely — is also important for individuals completing their rehabilitation. Our trained staff promotes success by addressing women’s and men’s health issues and training in use of equipment to in a community-based fitness environment. In addition, they explore new wellness opportunities that match a patient’s current fitness level and develop a plan to move forward with them after discharge. 

Clinical Expertise: Each patient’s care is directed by a physician who specializes in physiatry and/or a physician who specializes in internal medicine. A pediatrician is involved in daily to care for individuals 18 years or younger. Other physician specialists, such as pulmonologists, also provide consultation services at Madonna.   Madonna nurses are specially trained to care for patients with spinal cord injury, and several of our nurses have specialty training as a Certified Rehabilitation Registered Nurse. The spinal cord team has a rehab counselor who facilitates the team approach to adjustment to the disability, behavior health, and peer support services. The psychology staff provides family and support system counseling both individual and in a support group setting and provides support in the area of sexual adjustment.  Case management is also a  key part of the program in preparing patients and families for transitions across the lifespan, resource management, and how the importance of lifelong follow up with key health care providers. 

Treatment Equipment: Madonna is one of the region’s only rehabilitation hospitals to offer treatment equipment such as the RT-300, body weight support treadmill, Lokomat and EKSO to help individuals with incomplete SCI regain motor strength and control. Equipment options are available to serve pediatric individuals as well as individuals who may need bariatric accommodations.  Our research capability and rehab engineering staff extends our scope into development of new equipment and technology patients with SCI can benefit from now and in the future as well. 

Madonna features a multitude of assistive technology that assists individuals with any level of injury the opportunity to be more independent while using the telephone, accessing the computer and environmental control units. Examples include: voice-activated phones; voice-activated computer software; eye-gaze software; and environmental control systems using sip/puff or other switches.

Wheelchair Seating and Positioning: Selecting a wheelchair and following up after getting a new wheelchair are important to the overall long-term success of an individual with spinal cord injury. Pressure ulcers are a common and very costly secondary complication in persons with SCI. An adequate seating system is one way to prevent this complication. Madonna features an electronic pressure-mapping system that visually indicates pressure points, allowing clinicians to design and provide an appropriate seating system.

Preparation for Home: Madonna patients with spinal cord injury are provided with a 24-hour, caregiver-training program based on principles of self-advocacy and self-direction. We teach individuals, with or without identified caregivers, how to direct their care and what to do if emergencies arise. We provide opportunities for training in safety in the environments in which they participate both at home and the community.  Independent and community integration are facilitated through use of our transitional apartment and regular community outings.  Recommendations for home modifications are also made in partnership between our home assessment specialists, the team and the patient and family.

Community Reintegration: Rehabilitation does not stop when the patient gains basic skills of self-care and mobility. Madonna integrates a variety of  independent living skills into the program including adaptive sports and recreational outings into therapy, or just for fun. Patients may also visit with a vocational rehabilitation counselor about work re-entry, and may work on specific goals related to their return to driving or school.

Cutting-Edge Technology and Research

We continually develop and acquire new technologies to enhance the lives of patients entrusting their care to us. Combining technical expertise with the experience of our clinical teams is critical to patients returning to work, school and community.