Spinal Cord Injury Series Part 3: From Injury to Participation - Presented by Louise Condon

This session tackles two of the most clinically complex — and most rewarding — areas of SCI rehabilitation: getting the upper limb right in tetraplegia, and making evidence-based decisions about locomotor training and walking goals.
If you've ever wondered whether your patient will walk again, which training modality to choose, or how to approach upper limb rehab beyond basic strengthening — this session is for you.

What's Covered
Upper Limb Rehabilitation in Tetraplegia
Regaining arm and hand function is the number one priority for people living with tetraplegia — and the evidence is clear that targeted, well-structured upper limb physiotherapy makes a difference.

This section covers what to strengthen and why, the critical role of tenodesis grip at C6, splinting for functional positioning, shoulder pain prevention, and wheelchair propulsion technique. Practical, prioritised, and directly applicable to community practice.

Who Will Walk? 
Understanding the Evidence
Not every patient with incomplete SCI will achieve community ambulation — and setting realistic expectations early matters enormously. This section breaks down the walking recovery statistics by AIS grade, explains the van Middendorp Clinical Prediction Rule (validated in Australian practice), and shows you how to combine LEMS, AIS grade, and clinical judgement to have an honest, informed conversation about walking goals.

Locomotor Training — What the Evidence Actually Says
The research on locomotor training has some surprises. This section cuts through the noise — comparing bodyweight-supported treadmill training, robotic-assisted gait training, overground training, and FES — and tells you what the evidence actually shows. 
 

Spoiler: you don't need expensive equipment to deliver excellent locomotor rehabilitation. You need dose, intensity, and task-specificity.
Walking Aids & Orthoses, AFO, KAFO, RGO, FES, robotic exoskeleton — how do you match the device to the patient and the goal?

This section covers the evidence behind each option, realistic expectations around energy cost and abandonment rates, and a clear framework for clinical decision-making.

Walking Outcome Measures
When to use each, what they actually tell you, and the community ambulation thresholds that should be guiding your goals. Measurement done right turns clinical intuition into clinical evidence.