James – Spinal Cord Injury Rehabilitation at PhysioFunction

James sustained a T9 spinal cord injury (SCI) in 2012 at the age of 23 following a motorcycle accident. The injury resulted in complete paralysis from the waist down, requiring full-time use of a manual wheelchair. Fortunately, James retained full upper body function, which became a crucial asset in his rehabilitation. From the outset, he committed to regaining as much independence and physical ability as possible through a long-term physiotherapy programme.

Since then, James has undertaken a comprehensive and multifaceted rehabilitation journey aimed at promoting independence, improving physical health, and enhancing quality of life. His progress exemplifies the impact of a tailored, holistic approach to SCI rehabilitation that leverages advanced technologies and functional training.

Early Rehabilitation Goals

James began attending PhysioFunction in 2013, initially at the Moulton clinic before transitioning to Spratton. His early goals centred around:

• Improving upper body strength
• Enhancing core stability
• Gaining independence in wheelchair propulsion, transfers, and functional mobility

These foundational skills were critical in helping James take control of his daily life and minimise reliance on external support.

Physiotherapy Interventions

Over the years, James’ rehabilitation plan has evolved to reflect both his physical progress and personal aspirations. His treatment programme includes land-based physiotherapy, hydrotherapy, rehabilitation technology, and participation in adaptive sport.

• Upper Body and Core Strengthening

Land-based therapy focused on strengthening the upper limbs and trunk through targeted exercises such as pull-ups, resisted movements, and dynamic core challenges on the plinth and floor. These improvements have translated directly into functional abilities, including the capacity to lift and load his wheelchair into a car and perform floor-to-chair transfers; critical for safety and independence.

• Functional Electrical Stimulation (FES)

From the early stages, FES has played a central role in James’ rehab strategy. He uses FES cycling weekly to stimulate his lower limb muscles. This promotes cardiovascular fitness, reduces muscle atrophy, and helps manage spasticity.

He also engages in FES-assisted standing, which enables functional upright positioning to:

• Reduce the risk of pressure sores
• Improve circulation
• Maintain bone density

These techniques have been vital in preserving his long-term physical health and minimising secondary complications associated with SCI.

• Exoskeletons and Standing Frames

To counteract the effects of prolonged sitting and reduced skeletal loading, James integrated the REX exoskeleton and EasyStand standing frame into his therapy sessions. These tools facilitate safe weight-bearing through the lower limbs and support exercises in an upright posture. This not only contributes to bone and joint health but also supports improved core stability and postural alignment.

• Hydrotherapy

Hydrotherapy at Moulton Leisure Centre has provided James with a safe and supportive environment to practise movement, build confidence, and reduce the risk of injury. The buoyancy of water allowed him to regain mobility without the stress of gravity, and over time, he achieved his goal of swimming independently.

Sports and Functional Independence

James is a passionate athlete who has played wheelchair basketball for over 12 years. He currently competes in the National Wheelchair Basketball League, a demanding sport that requires significant upper body strength, stamina, and core control. His physiotherapy sessions have been tailored to reflect these demands, incorporating upper limb resistance training and conditioning to support athletic performance.

He also hand cycles to work using an adaptive handbike that clips onto his wheelchair; an activity that supports both his fitness and independence.

With enhanced strength and mobility, James is now able to:

• Transfer in and out of his car unaided
• Lift and store his wheelchair independently
• Complete floor transfers without assistance

These achievements are milestones that reflect the success of his goal-oriented rehabilitation and the restoration of autonomy in daily life.

Ongoing Rehabilitation Goals

James continues to attend weekly sessions at PhysioFunction to:

• Maintain muscle mass
• Reduce spasms
• Improve cardiovascular fitness
• Protect against osteoporosis and pressure sores

He remains committed to long-term health management through regular FES cycling, standing programmes, and dynamic upper body work.

Experience at PhysioFunction

For James, PhysioFunction is more than just a clinic — it’s a community.

“Although the main purpose of PhysioFunction is physiotherapy, it’s great meeting new people with a range of conditions — sharing experiences and tips. PhysioFunction has helped me become confident and independent living with my spinal cord injury.”

Advice to Others

“Live life as fully as you can and embrace trying new things, whether that be during physio sessions or whilst out and about.”

James’ story is an example of the power of long-term, client-centred rehabilitation. Through a consistent programme that includes FES, exoskeleton training, hydrotherapy, strength conditioning, and adaptive sport, James has not only preserved his physical health but also rediscovered his independence, confidence, and active lifestyle.

His journey demonstrates how individualised physiotherapy, advanced rehabilitation tools, and personal determination can work together to transform the lives of people living with spinal cord injuries.