Occupational Therapy for Spinal Cord Injury

The spinal cord houses nerves required to carry messages from the brain to the rest of our body and back again.  When there is a damage to the spinal cord, these messages are not able to travel properly.  This results in reduced ability to control movement. Body functions and/or sensation below the level of the injury will be impaired. Higher the injury, the more devastating the effects on the human body.



Occupational Therapists (OTs) play a key role in enabling Spinal Cord Injury (SCI) patients to restore function and return to productive lives. They assist individuals to reach their highest level of functional, physical and psychological independence, bearing in mind the extent of their impairment, home environment and their social situation.

Living well with Spinal Cord injury requires retraining oneself for daily activities and a lifelong commitment to maintaining healthy routines.  Occupational therapists help in the following ways:

  • Hand and upper limb management: Individual assessment of the hand and upper limb of patients is essential to maintain their hands in the optimum position for function, prevent contractures and deformities.  An occupational therapist can provide splints and exercise programs and alternative methods of working.
  • Housing adaptations:  Occupational therapists have expert knowledge on the housing needs of clients with a spinal cord injury. They work with the patient to learn how they wish to, and can live, in their home environment and then make recommendations to adapt it accordingly. They would include ramps, lifts and safety around the home.
  • Self-Care Activities: Self-Care activities such as eating, dressing, bathing, toileting,etc. can be a challenge for a person with a spinal cord injury.  Depending on the injury level, OTs can suggest the appropriate use of adaptive tools, splints or straps to consider.
  • Functional Transfers:  OTs can recommend different ways to improve transfers. This includes movements from/to the bed, around the home and around the community.  Transfer assistive devices include grab bars, patient hoists, transfer boards and bed rails.
  • Communication:  The role of the occupational therapist is to enable the patient to access alternative systems of communications. Individual writing splints or mouth sticks may be made to enable those with limited writing skills.
  • Wheelchair Mobility:  OTs are able to show the patient the proper way to use a wheelchair.  The occupational therapist guides the individual to trial and select a wheelchair with features that suit the patient’s functional ability and lifestyle.
  • Driving:  Specialized OTs can give information on special driver lessons and tests.  The OT can help with referrals, measurements and suitable vendors for adapted automobiles.
  • Leisure: Constructive use of leisure time is vital to maintain self-esteem and self-confidence. With the guidance of the OT, some previous activities and interests can be continued.  The OT will show the use of adapted recreation devices.
  • Work:   If a patient is planning to return to his or her previous employer, school, or college, the occupational therapist is able to assess the suitability of the premises for wheelchair accessibility and make recommendations on the facilities which would be necessary.
  • Pain Management:  The OT educates the patient on how to manage pain and methods to conserve energy while taking part in their daily activities.

Be sure to remember that any adaptation or change that is applied should be appropriate to the individual’s needs and enhance their quality of life rather than complicating it with unnecessary changes or equipment.






ABC of spinal cord injury – BMJ

The American Occupational Therapy Association