Lumbar spinal cord injury: how specific physiotherapy restored independence in walking

By Leticia Profeta, Physiotherapist

Some stories in neurological physiotherapy teach us that we should never underestimate the recovery potential of the nervous system. Today I share the case of a 56-year-old lady who, after years of dependence for walking, achieved her independence through a specific and persistent physiotherapy approach.

The accident: polytrauma with spinal cord injury

This patient suffered polytrauma - multiple simultaneous injuries in a severe accident. Among the various traumas, the most limiting was a spinal cord injury that resulted in paraplegia.

Initial Consequences:

• Paralysis of lower limbs

• Loss of sensation

• Balance impairment

• Total dependence for mobility

The scenario when I took on the case

When I began following this patient, she had already undergone years of physiotherapy and showed partial improvement:

Functional Condition:

• ✅ Could walk - but with severe limitations

• ❌ Could not stand up alone

• ❌ Required two people as lateral support

• ❌ Total dependence to initiate and maintain gait

"She had movement, but she didn't have independence - and this difference is fundamental for quality of life."

The reassessment: identifying the missing link

Upon conducting a detailed reassessment, I identified the central problem that was limiting her independence:

Physiotherapy diagnosis:

Complete absence of strength in the musculature responsible for balance

Specifically:

• Gluteus medius and gluteus maximus without function

• Deep lumbar musculature without activation

• Reduced postural control

The treatment protocol: specific stimulation

I developed a programme focused exclusively on strengthening the balance musculature:

Phase 1: Stimulation and Activation

• Daily passive mobilisation of lower limbs for abduction and adduction

• Tactile stimuli to awaken the musculature

• Repetitive flexion and extension movements

• Constant proprioceptive stimulation

Phase 2: First Signs of Life

After weeks of daily stimuli:

• First traces of muscle contraction appeared

• Minimal but detectable contractions

• Signs of neurological reconnection

Phase 3: Progressive Strengthening

• Resistance exercises with gradual weights

• Balance training in different positions

• Specific functional strengthening for gait

• Constant load progression

The result: independence achieved

After months of specific and persistent work:

🚶‍♀️ Independent Gait Achieved

• Walks alone without need for support

• Functional balance restored

• Confidence for independent mobility

• Quality of life drastically improved

Fundamental lessons from the case

1. Constant Reassessment is Essential

Even after years of treatment, a new perspective can identify aspects not adequately worked on.

2. Training Specificity

It's not enough to work "general strength" - one must focus on the specific musculature that is limiting function.

3. Neurological Persistence

The nervous system can respond even after long periods, provided it receives adequate stimuli.

4. Difference Between Movement and Function

• Movement: ability to move

• Function: ability to use movement functionally

Success factors in rehabilitation

Patient Factors:

• Motivation and determination

• Treatment adherence

• Family support

• General health status

Treatment Factors:

• Exercise specificity

• Adequate progression

• Session consistency

• Constant reassessment

Signs of hope in spinal cord injuries

When there's potential for improvement:

• Incomplete injuries (preservation of some function)

• Minimal voluntary movements

• Partially preserved sensation

• Present reflexes

"Never underestimate recovery potential - the nervous system can surprise us when it receives the correct stimuli."

Message of hope

This case demonstrates that even after years of functional limitation, a specific and persistent physiotherapy approach can generate extraordinary results. Independence in walking is not just about movement - it's about dignity, autonomy and quality of life.

Do you know someone with a spinal cord injury who hasn't yet reached their maximum recovery potential? A specialist reassessment may reveal new possibilities.

About the Author

Leticia Profeta is a physiotherapist with vast experience in spinal cord injuries and functional recovery. She dedicates herself to finding specific solutions for each patient, always believing in the potential for improvement.

Need specialist assessment for spinal cord injury? Book your consultation today.

This article is based on real clinical experience and is for educational purposes. Always consult qualified professionals for proper assessment and treatment.