Spinal Cord Injury Rehabilitation
The Spaulding-Harvard Spinal Cord Injury Model Systems (SCIMS) Rehabilitation Program provides an unparalleled level of care and support for individuals recovering from spinal cord injuries. From acute care and rehabilitation through community reentry, this comprehensive SCIMS Program maximizes neurorecovery while helping patients develop strategies for independent living. We treat patients who have suffered a spinal cord injury as a result of traumatic injury or as a result of illnesses such as polio, spina bifida or multiple sclerosis. We do this in a comfortable, supportive environment in which patients—with the help and support of their families—can attain the skills they need to return to their community.
Spaulding Boston also has an SCI Ventilator Program for patients requiring mechanical ventilation as a result of their injury. The focus of the program is on ventilator weaning for progression into a more intensive SCI program. Spaulding Boston is the first rehabilitation hospital in New England to use the Synapse Diaphragmatic Pacing System to facilitate weaning for ventilator dependent SCI patients.
Approach to Care
Within the Spaulding-Harvard SCI Model System, the goals of the Spinal Cord Injury program are to ensure optimal physical, emotional and social adjustment following a spinal cord injury, to maximize functional independence, and to improve quality of life. Our model system also promotes family participation. We offer training and education to help them play an active support role while their loved one is in the hospital and after he or she returns home.
Expertise
Our clinical teams draw on the most advanced research on spinal cord injury rehabilitation techniques, and have immediate access to the equipment, technology and specialists of the entire Spaulding network.
The flagship hospital of our network, the nationally renowned Spaulding Rehabilitation Hospital Boston, is a Center of Excellence in spinal cord injury rehabilitation.
Our interdisciplinary teams include physicians and nurses, physical, occupational, speech and respiratory therapists, therapeutic recreation specialists, psychologists, case managers, community resource specialists, social workers and vocational rehabilitation counselors. The Spaulding-Harvard SCI Model System staff works closely with the clinical team and is available to all patients with SCI and their family throughout their rehabilitation programs, and for life. In addition, we partner with the Greater Boston Chapter of the National Spinal Cord Injury Association to provide peer visitation so patients can learn from others who are living with spinal cord injury.
As one of 14 Spinal Cord Injury Model Systems (SCIMS) across the U.S., Spaulding is a recognized leader in medical research and patient care. All SCIMS work together to improve patient care, maintain a national database, provide long-term follow up, participate in independent and collaborative research and provide continuing education to individuals and families, healthcare professionals and the community-at-large.
Program Outcomes
All Spaulding Network facilities are accredited by the Joint Commission. Spaulding Rehabilitation Hospital Boston's Spinal Cord Injury program is accredited by CARF for both Adults and Child and Adolescent rehabilitation.
Program Director
Dr. Kevin O’Connor is the Medical Director for the Spinal Cord Injury program at Spaulding Rehabilitation Hospital Boston. He is board certified in Physiatry as well as Spinal Cord Injury Medicine. His career focus has been on improving the lives of those with a spinal cord injury. Dr. Leslie Morse is the Associate Director of Research and Director of Spinal Cord Injury Research and Program Director of the Spinal Cord Model Systems for the Spaulding Rehabilitation Network. Dr. Morse oversees several research studies are currently underway throughout the Network.
Research & Innovation
The Spaulding Network is committed to rehabilitation research to find best practices and opportunities to improve the lives of those with paralysis resulting from spinal cord injury. Our efforts not only focus on researching new rehabilitation strategies but also look at ways to prevent long-term complications related to paralysis.
Under the leadership of Dr. Leslie Morse, Associate Director of Research and Director of Spinal Cord Injury Research, several research studies are currently underway for SCI including:
Research Program
Investigation of the Mechanisms of Transcranial Direct Current Stimulation of Motor Cortex for the Treatment of Chronic Pain in Spinal Cord Injury
Description
As part of the Spaulding-Harvard SCI Model System research program, Dr. Felipe Fregni and his team are investigating the effects of transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, on chronic central pain in spinal cord injury. We are also using electroencephalography (EEG) and transcranial magnetic stimulation (TMS) to measure changes in the brain, both before and after tDCS. Our primary aim is to see if using tDCS stimulation can help reduce the chronic central pain associated with spinal cord injury.
Research Program
Investigation of the Mechanisms of Transcranial Direct Stimulation of Motor Cortex Coupled with Visual Illusion for the Treatment of Pain in Spinal Cord Injury
Description
Under the leadership of Dr. Felipe Fregni, Spaulding is investigating the effects of transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, combined with watching a visual illusion on chronic central pain associated with spinal cord injury. During tDCS stimulation, the participant watches a "visual illusion." The participant will see a video of walking legs on a treadmill, and their torso reflection in a mirror. They are asked to imagine themselves walking while they are watching the illusion. We are also using electroencephalography (EEG) and transcranial magnetic stimulation (TMS) to measure changes in the brain, both before and after tDCS. Our primary aim is to see if using a visual illusion combined with the tDCS stimulation can help reduce the chronic central pain associated with spinal cord injury.
Research Program
FES-Rowing versus Zoledronic Acid to Improve Bone Health in SCI: A Comparative Clinical Trial
Description
The project, which is funded by the Department of Defense and directed by Dr. Leslie Morse, aims to compare the effect of FES-row training alone versus FES-rowing plus Zoledronic Acid on bone density of the paralyzed lower extremity and to compare the effect of FES-row training alone versus FES-rowing plus Zoledronic Acid on bone micro architecture of the paralyzed lower extremity.
Research Program
Effectiveness and Generalizability of Hybrid-FES Exercise for Physiologic Declines in Spinal Cord Injury
Description
The purpose of this research project is to determine the effectiveness and generalizability of an unique aerobic exercise paradigm (hybrid FES-rowing) as an intervention to promote improved health and function in individuals with chronic SCI and to explore this form of exercise as a prevention for the declines that occur within the first years after acute SCI. Our primary outcomes relate to exercise capacity and cardiovascular risk, however given the range of effects exercise can have, we are examining secondary measures of bone density, pulmonary function, psychological effect, social integration, and clinical status.
Research Program
The Spaulding ExPD Program – FES-row Training for SCI
Description
Spaulding’s ExPD program’s mission is to provide appropriate exercise to improve health in those with physical disability. We focus on FES rowing for those with SCI, which requires a level of performance comparable to the able-bodied and can be integrated into currently existing communities of able-bodied rowers and therefore may be an optimal exercise intervention for the SCI population.
Research Program
Adiposity and Bone Loss in Spinal Cord Injury
Description
Under the leadership of Dr. Leslie Morse, Spaulding-Harvard SCI Model System is investigating the the degree of bone formation, bone resorption, and rate of bone loss longitudinally at the distal femur and proximal tibia in subjects with chronic SCI with varying degrees of neurologic impairment and in able-bodied subjects, and to determine the relationship between regional fat distribution assessed directly from DXA scan data and longitudinal change in BMD at the distal femur and proximal tibia, and assess the relationship between circulating levels of adipose derived hormones (leptin and adiponectin) with bone loss at the distal femur and proximal tibia.
Research Program
Longitudinal Assessment of Fracture Risk in Spinal Cord Injury
Description
SCI causes rabid and severe osteoporosis. This increases the risk of lower extremity fractures. Our study aims to determine the rate and location of post-SCI fractures as well as identifying risk factors for post-SCI fractures.
Locations
The Spaulding-Harvard Spinal Cord Injury Model Systems (SCIMS) Rehabilitation Program provides a full spectrum of rehabilitation care for SCI including Acute Rehabilitation Hospitals, Long Term Care Hospitals, and Skilled Nursing Facilities. Depending upon the individual circumstances and the level of care needed for the patient, one of the following Spaulding facilities may be recommended:
Inpatient
Spaulding Rehabilitation Hospital Boston
Spaulding Rehabilitation Hospital Cape Cod
Spaulding Hospital for Continuing Medical Care Cambridge
Spaulding Hospital for Continuing Medical Care North Shore
Spaulding Nursing and Therapy Center West Roxbury
Spaulding Nursing and Therapy Center North End
Related Services
The following services are related to the Spinal Cord Injury Rehabilitation Program at Spaulding.
Adaptive Sports
Armeo
Assistive Technology (ATEC)/ Alternative and Augmentative Communication (ACC)
Bioness
Brace Clinic/Prosthetics Clinic
Erigo
Exercise for Persons with Disability (ExPD)
Lokomat
Pressure Mapping Systems
Wheelchair/Seating Clinic
Spaulding-Harvard SCI Model System
Learn more about the Spaulding-Harvard Spinal Cord Injury Model System here.
