Page 72 - Read Online

Merritt et al. Neuroimmunol Neuroinflammation 2019;6:9 I http://dx.doi.org/10.20517/2347-8659.2019.15 Page 5 of 11

Figure 3. A flowchart illustrates the primary risk factors for a TSCI (blue) and the obstacles TSCI patients may face throughout their lives.
Decreased neurological recovery (yellow) is the factor that has the greatest negative impact on a patient. Access to rehabilitation (star)
is the only modifiable attribute shown that can reduce the cascade of negative events leading to a decreased patient quality of life. SES:
socioeconomic status; TSCI: traumatic spinal cord injury

[24]
through post-injury care delivered in an outpatient setting . While the timeframe of each of these phases
varies, neurological recovery has been found to occur during the acute and post-acute phases. This crucial
recovery period has been found to last between 12-18 months, with the majority of improvement observed
[25]
in the first 3 months post-injury . During the acute and post-acute phases, rehabilitation seeks maximize
neurological recovery as measured by the ASIA grade [26,27] . A patient will enter the chronic phase when
they have reached their maximum neurological recovery; therefore, priorities in the chronic phase shift to
minimizing common long-term TSCI co-morbidities and normalizing a patient’s new post-injury standard
[28]
of living . The neurological recovery and the quality of life of the TSCI patients are dependent on various
primary risk factors and the obstacles that they may face throughout their lives [Figure 3].

To date, few studies have examined the recovery rates corresponding with the time between TSCI and
[23]
initiation of rehabilitation . Regardless, studies have shown TSCI patients having access to rehabilitation
corresponds to better outcomes and a greater chance for patients to reclaim their roles as active members of