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.