Spinal rehab should focus on mind, says study

Rehabilitation from spinal injuries should focus on the mind as well as the body, according to research

Health experts believe training in spatial awareness for patients would increase rates of recovery.

A study led by Heriot-Watt University found that even when an individual’s upper limbs are unaffected by a spinal injury, it often changed their perception of their reach and how they perceived the space in front of them.

The changes can affect a “multitude of everyday tasks ranging from lifting a cup of tea and eating to daily self-care”, study leader Dr Anna Sedda said.

The team, which included researchers and experts based in Italy, Switzerland and the UK, believe the findings could help the NHS, charities and other organisations supporting individuals currently living with paraplegia, and gives new insights into how homes should be adapted.

Dr Sedda, assistant professor of psychology at Heriot-Watt, said: “The study provides evidence that the physical change occurring in the ability to move around freely in paraplegia has a direct influence on how our brain translates an object’s properties into sensory signals.

“By comparing the results of individuals with paraplegia and individuals of the same age who have no spinal cord injury in computerised tasks, we found that patients with paraplegia do not overestimate the space they can reach with their hands, as one would normally do given our ability to push a bit further using our torso.

“They also show more variability in spatial judgments which are not helped by having the target objects moved nearer to them.

“The findings suggest that individuals with paraplegia do not make use of an object’s properties that are related to the subsequent action, and that this difference in perception is related to the everyday experience of using their body differently after the injury.

The study, Affordances after spinal cord injury, has been published in the Journal of Neuropsychology.

Dr Sedda added: “At present, approximately 25 per cent of those with spinal cord lesions who have retained sensory function fail to regain the use of their lower limbs and we don’t yet know why this is.

“By delivering mind rehabilitation, in partnership with physical rehabilitation, we believe we could improve the outcomes for these specific individuals, potentially allowing them to regain movement in their lower limbs.”