Community-based activity-based therapy for spinal cord injuries rehabilitation

This chapter addresses theoretical and practical aspects of the application of activity-based therapies in community settings for people with spinal cord injuries. Activity-based therapy is a relatively novel approach that, differently from traditional rehabilitation of spinal cord injuries, aims to promote sensorimotor recovery of the paralyzed or partially paralyzed body parts below the neurological level of injury. Activity-based therapy is based on the scientific evidence that the spinal cord has the ability to “learn” and undergo plastic changes after injury in response to intensive task-specific training. Activity-based therapy is an umbrella term that includes a range of therapeutic interventions that focus on optimizing the nervous system function, improving and maintaining health, and increasing independence and participation after a spinal cord injury. Locomotor training, functional electrical stimulation, whole body muscle strength, and activities where load is applied to the paralyzed or partially paralyzed extremities are examples of activity-based therapy interventions that will be discussed in this chapter, with the focus on its scientific evidence, practical aspects and applications in community settings for people with spinal cord injuries.