Effects of Pre-Surgery Physiotherapy on Walking Ability and Lower Extremity Strength in Spinal Cord Injury Patients: An Experimental Study

Authors

  • Emammer Khalifa Emammer MSPT, Associate Professor, Department of Physical Therapy, Higher Institute of Medical Technology Bani Waleed, Libya. Head of the Allied Medical Professions Union, Bani Walid.
  • Dr. Ali Mehemed Shauosh Ph.D., Associate Professor, Head of Libyan Association for Physical Therapy - Member of Arab Confederation for Physical Therapy
  • Rabeeah Tariq Mohammed Student, Department of Physical Therapy, Higher Institute of Medical Technology, Bani Waleed.
  • Fatimah Jummah Hasan Student, Department of Physical Therapy, Higher Institute of Medical Technology, Bani Waleed

Keywords:

Spinal Cord Injury, Pre-surgery Physiotherapy, Walking Ability, Lower Extremity Strength, Randomized Controlled Trial, Quality of Life, Rehabilitation

Abstract

The research investigated how pre-surgical physiotherapy affects walking abilities and strength measurements in individuals who suffer from Spinal Cord Injury (SCI). A randomized controlled trial consisting of 100 participants separated their participants into two equal groups for treatment and monitoring purposes. Assessments of walking ability were made using the 10-meter walk test, and lower limb strength was evaluated through isokinetic dynamometry. Patients reported their muscle tone, range of motion and quality of life alongside the primary outcomes. The data showed that participants who underwent pre-surgery physiotherapy treatments reached significantly superior results in mobility and strength and better wellbeing than participants in the control group. The research data proves that pre-surgical physiotherapy belongs to standard rehabilitation plans for patients with spinal cord injuries. Apart from improving physical abilities, the intervention delivered positive advantages that enhanced quality of life outcomes for participants. Research needs to continue studying both the extended advantages and functional gain durability after SCI in addition to developing customized preoperative rehabilitation treatments for people who have spinal cord injuries.

References

Afreen, S., Mazhar, K., Malik, R., & Asif, I. (2021). Role of Neuroplasticity in Neurorehabilitation. Asia Pac. J. Allied Health Sci. Vol., 4, 46-51.

Ahuja, C. S., Wilson, J. R., Nori, S., Kotter, M., Druschel, C., Curt, A., & Fehlings, M. G. (2017). Traumatic spinal cord injury. Nature reviews Disease primers, 3(1), 1-21.

Alhazmi, A. M., Hakami, M. A., Aldosari, O. M. O., Al-Kharif, S. A., Alduhaish, A. A., Alrshood, A. S. S., ... & Almubarak, A. I. M. (2024). Rehabilitation Programs for Patients with Spinal Cord Injuries Updated Review. Egyptian Journal of Chemistry, 67(13), 1603-1611.

Alotaibi, N. S. M., Al-Thawbani, M. A. Y., Albalawi, I. M. R., Altalyan, A. A. N., Alotaibi, T. O., & Al-Asiri, M. A. M. (2024). Patient Education: Preparing For And Recovering From Orthopedic Surgery. Tec Empresarial, 6(2), 1016-1033.

Baldania, S., & Baladaniya, M. (2024). Improved Movement, Improved Life: The Vital Contribution of Physical Therapy to Orthopaedic Resilience. International Journal of Physiotherapy (IJPH), 2(1), 1-18.

Barker, L. (2024). How to Build a Brainstem. In How to Build a Human Brain (pp. 41-75). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-55297-7_2

Barrett, O. E., Ho, A. K., & Finlay, K. A. (2022). Supporting sexual functioning and satisfaction during rehabilitation after spinal cord injury: barriers and facilitators identified by healthcare professionals. Journal of Rehabilitation Medicine, 54, 1413. https://doi.org/10.2340/jrm.v54.1413

Barth, C. A., Donovan-Hall, M., Blake, C., Jahan Akhtar, N., Capo-Chichi, J. M., & O’sullivan, C. (2021). A focus group study to understand the perspectives of physiotherapists on barriers and facilitators to advancing rehabilitation in low-resource and conflict settings. International journal of environmental research and public health, 18(22), 12020.

Bednar, D. (2023). The Back Story on Spine Care: A Surgeon’s Insights on Relieving Pain and Advocating for the Right Treatment to Get Your Life Back. ECW Press.

Biering-Sørensen, F., Burns, S. P., Graves, D. E., Guest, J., Jones, L., Read, M. S., ... & Kirshblum, S. (2021). International standards for neurological classification of spinal cord injury. Topics in Spinal Cord Injury Rehabilitation, 27(2), 1-22. DOI:10.46292/sci2702-1

Biswas, S. S. (2023). Clinical Practice Guideline of Physiotherapy Intervention for Lower Limb on Spinal Cord Injury. http://hdl.handle.net/123456789/1090

Biz, C., Khamisy-Farah, R., Puce, L., Szarpak, L., Converti, M., Ceylan, H. ?., ... & Ruggieri, P. (2024). Investigating and practicing orthopedics at the intersection of sex and gender: understanding the physiological basis, pathology, and treatment response of orthopedic conditions by adopting a gender lens: a narrative overview. Biomedicines, 12(5), 974.

Budd, M. A., Gater Jr, D. R., & Channell, I. (2022). Psychosocial consequences of spinal cord injury: a narrative review. Journal of personalized medicine, 12(7), 1178. https://doi.org/10.3390/jpm12071178

Buyruk, H. M., Buyruk, Y., & Ince, C. (2022). Acute Medical Rehabilitation in Intensive Care. In Annual Update in Intensive Care and Emergency Medicine 2022 (pp. 385-396). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-93433-0_29

Calverley, J. R. (2024). Understanding prehab behaviour: Capability, opportunity, and motivation for pre-operative physical activity in osteoarthritis patients (Doctoral dissertation, University of Otago).

Campbell, P., Pope, R., Simas, V., Canetti, E., Schram, B., & Orr, R. (2022). The effects of early physiotherapy treatment on musculoskeletal injury outcomes in military personnel: a narrative review. International journal of environmental research and public health, 19(20), 13416. https://doi.org/10.3390/ijerph192013416

Canseco, J. A., Karamian, B. A., Bowles, D. R., Markowitz, M. P., DiMaria, S. L., Semenza, N. C., ... & Vaccaro, A. R. (2021). Updated review: the steroid controversy for management of spinal cord injury. World neurosurgery, 150, 1-8. https://doi.org/10.1016/j.wneu.2021.02.116

Carayannopoulos, A., Johnson, D., Lee, D., Giuffrida, A., Poply, K., Mehta, V., ... & Heros, R. (2024). Precision rehabilitation after neurostimulation implantation for multifidus dysfunction in nociceptive mechanical chronic low back pain. Archives of Rehabilitation Research and Clinical Translation, 6(2), 100333. https://doi.org/10.1016/j.arrct.2024.100333

CASE, S. (2025). mies? What is surgical positioning for thyroidectomy? What pre-Rheumatoid arthritis (RA) is an autoimmune disease that. Perioperative Medicine: A Problem-Based Learning Approach, 77.

Cordero, J. F. B., Carrascal, A. M. Z., Chávez, Á. F. L., Graciano, E. D., Bonilla, J. A. A., Caro, L. F. O., ... & Lora, J. F. V. (2022). Multidisciplinary Approach in the Treatment of Patients with Spinal Injuries. Health Science Journal, 16, 1-6. DOI:10.36648/1791-809X.16.S6.925

Cui, C. X., Liu, H. Y., Yue, N., Du, Y. R., Che, L. M., & Yu, J. S. (2023). Research progress on the mechanism of chronic neuropathic pain. IBRO Neuroscience Reports, 14, 80-85. https://doi.org/10.1016/j.ibneur.2022.12.007

Daun, M. K., & Davis, K. W. (2023). Principles and Complications of Orthopedic Hardware. In Musculoskeletal Imaging (pp. 1-27). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-57376-8_100-1

Di Bello, F., Creta, M., Napolitano, L., Califano, G., Passaro, F., Morra, S., ... & Longo, N. (2022). Male sexual dysfunction and infertility in spinal cord injury patients: state-of-the-art and future perspectives. Journal of Personalized Medicine, 12(6), 873. https://doi.org/10.3390/jpm12060873

Diwan, A. D., & Melrose, J. (2023). Intervertebral disc degeneration and how it leads to low back pain. JOR spine, 6(1), e1231. https://doi.org/10.1002/jsp2.1231

Dobkin, B. H. (2021). Paraplegia and spinal cord syndromes. Bradley’s Neurology in Clinical Practice E–Book, 356.

Dreiling, M. L. (2022). Promoting Adherence To Lymphedema Manageemnt: A Resource Guide For Ot Practitioners In Interprofessional Teams.

Drossopoulos, P. N., Sharma, A., Ononogbu-Uche, F. C., Tabarestani, T. Q., Bartlett, A. M., Wang, T. Y., ... & Abd-El-Barr, M. M. (2024). Pushing the limits of minimally invasive spine surgery—from preoperative to intraoperative to postoperative management. Journal of clinical medicine, 13(8), 2410. https://doi.org/10.3390/jcm13082410

Dubuc, N., & Beresford, B. (2021). Reablement: a unique approach to regaining, maintaining, or improving independence in daily life. Promoting the Health of Older Adults: The Canadian Experience. Tornoto: Canadian Scholars, 421-433.

Etha, T. A. (2022). Age variance on neurologic and functional recovery of traumatic paraplegic spinal cord injury patients after completion rehabilitation program from CRP (Doctoral dissertation, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh). http://hdl.handle.net/123456789/882

Farah, G. J., Mitchell, B. C., Schmitz, M. R., Bomar, J. D., & Edmonds, E. W. (2022). Injury Patterns in Rugby Union—America’s Fastest Growing Sport. Journal of the Pediatric Orthopaedic Society of North America, 4(1), 406. https://doi.org/10.55275/JPOSNA-2022-0019

Faruki, M. H. (2023). “Effectiveness of functional electrical stimulation (FES) of knee extensors and hip extensors in paraplegic participants at a specialized rehabilitation unit (Doctoral dissertation, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh). http://hdl.handle.net/123456789/999

Fiani, B., Arshad, M. A., Shaikh, E. S., Baig, A., Farooqui, M., Ayub, M. A., ... & Quadri, S. A. (2021). Current updates on various treatment approaches in early acute spinal cord injury management. Reviews in the Neurosciences, 32(5), 513-530.

Fors, M., Enthoven, P., Abbott, A., & Öberg, B. (2019). Effects of pre-surgery physiotherapy on walking ability and lower extremity strength in patients with degenerative lumbar spine disorder: Secondary outcomes of the PREPARE randomised controlled trial. BMC Musculoskeletal Disorders, 20(1), 468. https://doi.org/10.1186/s12891-019-2850-3

Gait training. (n.d.). In Wikipedia. Retrieved from https://en.wikipedia.org/wiki/Gait_training

Gregory, C. M., & Bickel, C. S. (2007). Recruitment patterns in human skeletal muscle during electrical stimulation. Journal of Applied Physiology, 103(4), 1296-1304. https://doi.org/10.1152/japplphysiol.00174.2007

Güngör, Z. K. (2024). Rehabilitation of Spinal Cord Injuries. DOI: 10.5772/intechopen.1007372

Harvey, L. A. (2016). Physiotherapy rehabilitation for people with spinal cord injuries. Journal of physiotherapy, 62(1), 4-11. https://doi.org/10.1016/j.jphys.2015.11.004

Hasnakipour, S., Mosallanezhad, Z., Rezaeian, T., Azadi, F., & Noroozi, M. (2025). The effect of diaphragmatic breathing exercise with biofeedback on respiratory function in incomplete cervical spinal cord injury: A randomized-controlled study. American Journal of Physical Medicine & Rehabilitation, 10-1097. DOI: 10.1097/PHM.0000000000002714

Health, D. (2025, January 31). Recovering From Surgery Is Hard. 'Prehabilitation' Could Make it Easier. Health.com. Retrieved from https://www.health.com/prehabilitation-easier-surgery-recovery-study-8782957

Hesbach, C. D. A. (2024). Passive Range of Motion (PROM). Physical Rehabilitation for Veterinary Technicians and Nurses, 76.

Hillegass, E., Lukaszewicz, K., & Puthoff, M. (2022). Role of physical therapists in managing individuals at risk for or diagnosed with venous thromboembolism: evidence-based clinical practice guideline 2022. Physical therapy, 102(8), pzac057. https://doi.org/10.1093/ptj/pzac057

Howland, D. R., Trimble, S. A., Fox, E. J., Tester, N. J., Spiess, M. R., Senesac, C. R., ... & Behrman, A. L. (2023). Recovery of walking in nonambulatory children with chronic spinal cord injuries: Case series. Journal of neuroscience research, 101(6), 826-842. https://doi.org/10.1002/jnr.25162

Hsieh, S., & Gibbs, K. (2025). Performing and Interpreting the ISNCSCI/ASIA Exam for Spinal Cord Injury Classification. Current Physical Medicine and Rehabilitation Reports, 13(1), 14. https://doi.org/10.1007/s40141-025-00485-7

Hu, X., Xu, W., Ren, Y., Wang, Z., He, X., Huang, R., ... & Cheng, L. (2023). Spinal cord injury: molecular mechanisms and therapeutic interventions. Signal transduction and targeted therapy, 8(1), 245.

Huang, L., Li, M., Deng, C., Qiu, J., Wang, K., Chang, M., ... & Sun, H. (2022). Potential therapeutic strategies for skeletal muscle atrophy. Antioxidants, 12(1), 44. https://doi.org/10.3390/antiox12010044

Husssin, S., Khan, M. A., Raza, T., Haider, M. M., Javaid, J., Rafiq, A., ... & Haq, M. I. U. (2023). The Role of Spinal Instability in Treating Unstable Infected Fractures. Pakistan Journal of Medical & Health Sciences, 17(09), 73-73. https://doi.org/10.53350/pjmhs2023170973

Hyland, S. J., Brockhaus, K. K., Vincent, W. R., Spence, N. Z., Lucki, M. M., Howkins, M. J., & Cleary, R. K. (2021, March). Perioperative pain management and opioid stewardship: a practical guide. In Healthcare (Vol. 9, No. 3, p. 333). MDPI. https://doi.org/10.3390/healthcare9030333

Jain, S. N., Lamture, Y., & Krishna, M. (2023). Enhanced recovery after surgery: exploring the advances and strategies. Cureus, 15(10).

Jiang, G., Zhang, J., Yin, X., Zhang, Z., Liu, Q., Xing, H., ... & He, Y. (2023). Spinal Cord and Spinal Canal Infections and Inflammatory Diseases. In Radiology of Infectious and Inflammatory Diseases-Volume 1: Brain and Spinal Cord (pp. 255-304). Singapore: Springer Nature Singapore. https://doi.org/10.1007/978-981-99-0039-8_20

Jin, L. Y., Li, J., Wang, K. F., Xia, W. W., Zhu, Z. Q., Wang, C. R., ... & Liu, H. Y. (2021). Blood–spinal cord barrier in spinal cord injury: a review. Journal of neurotrauma, 38(9), 1203-1224. https://doi.org/10.1089/neu.2020.7413

Kamardeen, I., & Hasan, A. (2023). Analysis of work-related psychological injury severity among construction trades workers. Journal of Management in Engineering, 39(2), 04023001. https://doi.org/10.1061/JMENEA.MEENG-5041

Karim, S., Chahal, A., Khanji, M. Y., Petersen, S. E., & Somers, V. (2023). Autonomic cardiovascular control in health and disease. Comprehensive Physiology, 13(2), 4493. https://doi.org/10.1002/cphy.c210037

Karunarathna, I., De Alvis, K., Gunasena, P., & Jayawardana, A. (2024). Perioperative and intensive care management of chronic obstructive pulmonary disease (COPD) patients: A comprehensive review. http://dx.doi.org/10.13140/RG.2.2.31073.31846

Kirshblum, S., Botticello, A., Benedetto, J., Eren, F., Donovan, J., & Marino, R. (2022). Characterizing natural recovery of people with initial motor complete tetraplegia. Archives of Physical Medicine and Rehabilitation, 103(4), 649-656. https://doi.org/10.1016/j.apmr.2021.09.018

Kirshblum, S., Snider, B., Botticello, A., Benedetto, J., & Engel-Haber, E. (2025). The Role of Motor Zones of Partial Preservation in Conversion from Initially Complete to Motor Incomplete Spinal Cord Injury. Archives of Physical Medicine and Rehabilitation. https://doi.org/10.1016/j.apmr.2025.01.473

Kirshblum, S., Snider, B., Eren, F., & Guest, J. (2021). Characterizing natural recovery after traumatic spinal cord injury. Journal of neurotrauma, 38(9), 1267-1284. https://doi.org/10.1089/neu.2020.7473

Kolli, S., Medina, R., DeYoung, C., & Lucke?Wold, B. (2024). Cervical collar use in spinal cord injury management. Clinical and Translational Discovery, 4(3), e316. https://doi.org/10.1002/ctd2.316

Kralj, A., & Bajd, T. (2022). Functional electrical stimulation: standing and walking after spinal cord injury. Routledge. https://doi.org/10.1201/9780203755402

Krishna, A., Mohanty, D., Athiyamaan, M. S., & Simon, P. (2024). Disabilities in Cancer Patients and Rehabilitation Approaches. In The Palgrave Encyclopedia of Disability (pp. 1-10). Cham: Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-40858-8_361-2

Kuiper, H., van Leeuwen, C. C., Kopsky, D. J., Stolwijk-Swüste, J. M., & Post, M. W. (2021). Post-traumatic stress disorder symptoms and pain intensity in persons with spinal cord injury. Spinal cord, 59(3), 328-335. https://doi.org/10.1038/s41393-020-00599-w

Kumar, P., & Chawla, J. K. (2023). Rehabilitation in Lumbar Spinal Surgery. In Frontiers in Spinal Neurosurgery. IntechOpen. DOI: 10.5772/intechopen.1001938

Kuris, E. O., Alsoof, D., Osorio, C., & Daniels, A. H. (2022). Bowel and bladder care in patients with spinal cord injury. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 30(6), 263-272. DOI: 10.5435/JAAOS-D-21-00873

Lam, K., Kwan, J. S., Kwan, C. W., & Chi, I. (2022). Factors associated with development of new joint contractures in long-term care residents. Journal of the American Medical Directors Association, 23(1), 92-97. https://doi.org/10.1016/j.jamda.2021.05.036

Leszczy?ska, K., & Huber, J. (2023). Unveiling the correlations between clinical assessment of spasticity and muscle strength and neurophysiological testing of muscle activity in incomplete spinal cord injury patients: the importance of a comprehensive evaluation. Applied Sciences, 13(13), 7609. https://doi.org/10.3390/app13137609

Li, W., & Xu, D. (2021). Application of intelligent rehabilitation equipment in occupational therapy for enhancing upper limb function of patients in the whole phase of stroke. Medicine in Novel Technology and Devices, 12, 100097. https://doi.org/10.1016/j.medntd.2021.100097

Linck, G., & Boissonnault, B. (2024). Symptom Investigation: Screening for Medical Conditions. In Foundations of Orthopedic Physical Therapy (pp. 80-104). Routledge.

Litak, J., Szymoniuk, M., Czy?ewski, W., Hoffman, Z., Litak, J., Sakwa, L., & Kamieniak, P. (2022). Metallic implants used in lumbar interbody fusion. Materials, 15(10), 3650. https://doi.org/10.3390/ma15103650

McClure, J., & Leah, C. (2021). Is independence enough? Rehabilitation should include autonomy and social engagement to achieve quality of life. Clinical Rehabilitation, 35(1), 3-12. https://doi.org/10.1177/0269215520954344

Melesse, D. Y., Tesema, T. T., Mekonnen, Z. A., & Chekol, W. B. (2024). Airway Management for Individuals with Suspected or Confirmed Traumatic Cervical Spine Injuries: A Comprehensive Review and Analysis. Perioperative Care and Operating Room Management, 100390. https://doi.org/10.1016/j.pcorm.2024.100390

Mneimneh, F. (2021). Personal Cooling Strategies for Alleviating the Thermal Strain of People with Spinal Cord Injury (Doctoral dissertation).

Moore, J. A. (2023). Improving Surgical Outcomes in Greater Manchester (Doctoral dissertation, The University of Manchester (United Kingdom).

Murray, A., Watter, K., McLennan, V., Vogler, J., Nielsen, M., Jeffery, S., ... & Kennedy, A. (2022). Identifying models, processes, and components of vocational rehabilitation following acquired brain injury: a systematic scoping review. Disability and rehabilitation, 44(24), 7641-7654. https://doi.org/10.1080/09638288.2021.1980622

Niemi-Nikkola, V. (2021). Spinal fractures and spinal cord injuries: incidence, epidemiological characteristics and survival. https://urn.fi/URN:ISBN:9789526228105

Nistor-Cseppento, C. D., Gherle, A., Negrut, N., Bungau, S. G., Sabau, A. M., Radu, A. F., ... & Uivarosan, D. (2022). The outcomes of robotic rehabilitation assisted devices following spinal cord injury and the prevention of secondary associated complications. Medicina, 58(10), 1447. https://doi.org/10.3390/medicina58101447

Nizamis, K., Athanasiou, A., Almpani, S., Dimitrousis, C., & Astaras, A. (2021). Converging robotic technologies in targeted neural rehabilitation: a review of emerging solutions and challenges. Sensors, 21(6), 2084. https://doi.org/10.3390/s21062084

Noamani, A., Lemay, J. F., Musselman, K. E., & Rouhani, H. (2021). Characterization of standing balance after incomplete spinal cord injury: Alteration in integration of sensory information in ambulatory individuals. Gait & Posture, 83, 152-159. https://doi.org/10.1016/j.gaitpost.2020.10.027

Oladele, D. A., Markus, E. D., & Abu-Mahfouz, A. M. (2021). Adaptability of assistive mobility devices and the role of the internet of medical things: Comprehensive review. JMIR Rehabilitation and Assistive Technologies, 8(4), e29610.

Osagwu, M., Okobi, E., & Ekor, E. (2024). Postoperative infections: risk factors, prevention, and management strategies. Int J Med Sci Dent Res, 7, 52-76.

Patek, M., & Stewart, M. (2023). Spinal cord injury. Anaesthesia & Intensive Care Medicine, 24(7), 406-411. https://doi.org/10.1016/j.mpaic.2023.04.006

Perrouin-Verbe, B., Lefevre, C., Kieny, P., Gross, R., Reiss, B., & Le Fort, M. (2021). Spinal cord injury: a multisystem physiological impairment/dysfunction. Revue neurologique, 177(5), 594-605. https://doi.org/10.1016/j.neurol.2021.02.385

Picariello, F., Carbone, M. M., Barni, L., Sánchez, M. G., Galán-Mercant, A., & Meyer, P. F. (2025). The Physiotherapist: The Importance of Early Functional Recovery. In The Frail Surgical Patient: A Geriatric Approach Beyond Age (pp. 321-349). Cham: Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-77707-3_23

Ponzano, M., Buren, R., Adams, N. T., Jun, J., Jetha, A., Mack, D. E., & Ginis, K. A. M. (2024). Effect of exercise on mental health and health-related quality of life in adults with spinal cord injury: a systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation. https://doi.org/10.1016/j.apmr.2024.02.737

Porche, K., Hoh, D. J., Mohamed, B., Polifka, A., & Decker, M. (2024). Complex Spine Surgery. In Textbook of Neurointensive Care: Volume 2: Perioperative Management, Monitoring, Pharmacotherapy (pp. 37-59). Cham: Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-62224-3_3

Prehabilitation for Patients Undergoing Orthopedic Surgery. (2021). JAMA Network Open, 4(1), e2035951. https://doi.org/10.1001/jamanetworkopen.2020.35951

Prins, C. A., de Oliveira, F. L., de Mello Coelho, V., dos Santos Ribeiro, E. B., de Almeida, J. S., Silva, N. M. B., ... & Martinez, A. M. B. (2024). Galectin-3 absence alters lymphocytes populations dynamics behavior and promotes functional recovery after spinal cord injury in mice. Experimental Neurology, 377, 114785. https://doi.org/10.1016/j.expneurol.2024.114785

Ratri, T. T. (2023). Physical disability and functional independence of spinal cord injury patients in the community after completing rehabilitation from Specialized Rehabilitation Centre (Doctoral dissertation, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh). http://hdl.handle.net/123456789/1024

Razzaghi, V., Ostadhashemi, L., Arshi, M., & Sabzi Khoshnami, M. (2023). Exploring the facilitators and barriers of social integration of patients with spinal cord injuries in Rofeideh Rehabilitation Hospital: A qualitative study. Archives of Rehabilitation, 23(4), 482-501.

Roolfs, L., Hubertus, V., Spinnen, J., Shopperly, L. K., Fehlings, M. G., & Vajkoczy, P. (2022). Therapeutic approaches targeting vascular repair after experimental spinal cord injury: a systematic review of the literature. Neurospine, 19(4), 961. https://doi.org/10.14245/ns.2244624.312

Rosner, J., Lütolf, R., Hostettler, P., Villiger, M., Clijsen, R., Hohenauer, E., ... & Hubli, M. (2021). Assessment of neuropathic pain after spinal cord injury using quantitative pain drawings. Spinal Cord, 59(5), 529-537. https://doi.org/10.1038/s41393-021-00616-6

Rupp, R. (2021). Spinal Cord Injury. In Neuroprosthetics and Brain-Computer Interfaces in Spinal Cord Injury: A Guide for Clinicians and End Users (pp. 3-35). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-68545-4_1

Rupp, R., Biering-Sørensen, F., Burns, S. P., Graves, D. E., Guest, J., Jones, L., ... & Kirshblum, S. (2021). International standards for neurological classification of spinal cord injury: revised 2019. Topics in spinal cord injury rehabilitation, 27(2), 1. https://doi.org/10.46292/sci2702-1

Saifee, T., Farmer, S., Shah, S., & Choi, D. (2024). Spinal column and spinal cord disorders. Neurology: a queen square textbook, 463-498.

Sakaguchi, T., Heyder, A., Tanaka, M., Uotani, K., Omori, T., Kodama, Y., ... & Nakagawa, M. (2024). Rehabilitation to improve outcomes after cervical spine surgery: narrative review. Journal of Clinical Medicine, 13(18), 5363. https://doi.org/10.3390/jcm13185363

Scheel-Sailer, A., Melissa, S. E. L. B., Gmünder, H. P., Baumberger, M., Armin, C. U. R. T., Margret, H. G., ... & Group, D. R. I. (2021). Towards the implementation of clinical quality management at the national level: description of current types of rehabilitation services for spinal cord injury/disorder in Switzerland using an interdisciplinary consensus process. European journal of physical and rehabilitation medicine, 58(2), 190. https://doi.org/10.23736/S1973-9087.21.06923-9

Schultz, K. R., Mona, L. R., & Cameron, R. P. (2022). Mental health and spinal cord injury: clinical considerations for rehabilitation providers. Current physical medicine and rehabilitation reports, 10(3), 131-139. https://doi.org/10.1007/s40141-022-00349-4

Schumann, M., Feuerbacher, J. F., Sünkeler, M., Freitag, N., Rønnestad, B. R., Doma, K., & Lundberg, T. R. (2022). Compatibility of concurrent aerobic and strength training for skeletal muscle size and function: an updated systematic review and meta-analysis. Sports Medicine, 52(3), 601-612. https://doi.org/10.1007/s40279-021-01587-7

Sede di Grosseto, S. E. (2022). Pathology/Biology_2022. MEEeflNG AND SURPASSING TH· E CHALluENGES OF A 00 e M OD 8 R N, FORE N S· ICSCIE N CE 1 WORLD., 737.

Silva Guerrero, A. V., Setchell, J., Maujean, A., & Sterling, M. (2022). “I’ve learned to look at things in a different way”: exploring patients’ perspectives on participation in physiotherapist delivered integrated stress inoculation training and exercise for acute whiplash. Disability and Rehabilitation, 44(18), 5191-5198. https://doi.org/10.1080/09638288.2021.1931480

Somers, M., & Bender-Burnett, J. (2024). Spinal cord injury: functional rehabilitation. FA Davis.

Stier, G. R., Vandse, R., & Cole, D. J. (2025). Neurosurgical diseases and trauma of the spine and spinal cord: anesthetic considerations. In Cottrell & Patel's Neuroanesthesia (pp. 390-449). Elsevier. https://doi.org/10.1016/B978-0-323-93273-8.00021-3

Sutor, T. W., Kura, J., Mattingly, A. J., Otzel, D. M., & Yarrow, J. F. (2022). The effects of exercise and activity-based physical therapy on bone after spinal cord injury. International Journal of Molecular Sciences, 23(2), 608. https://doi.org/10.3390/ijms23020608

Tabarestani, T. Q., Lewis, N. E., Kelly-Hedrick, M., Zhang, N., Cellini, B. R., Marrotte, E. J., ... & Abd-El-Barr, M. M. (2022). Surgical considerations to improve recovery in acute spinal cord injury. Neurospine, 19(3), 689.

Taye, W. A. (2024). A review of the evolution and advancements of neurological physical therapy. Journal of Biomedical and Sustainable Healthcare Applications, 4(1), 63-72.

Tian, T., Zhang, S., & Yang, M. (2023). Recent progress and challenges in the treatment of spinal cord injury. Protein & cell, 14(9), 635-652. https://doi.org/10.1093/procel/pwad003

Torres, F., Puente, S., & Ubeda, A. (Eds.). (2020). Assistance Robotics and Biosensors 2019. MDPI.

Wang, Z. J., Du, Q., Wang, S. F., Su, H., He, W., Liao, W. B., ... & Kong, W. J. (2024). Anterior transcorporeal approach combined with posterior translaminar approach in percutaneous endoscopic cervical discectomy for two-segment cervical disc herniation treatment: a technical report and early follow-up. Journal of Orthopaedic Surgery and Research, 19(1), 3. https://doi.org/10.1186/s13018-023-04471-4

Zhang, Y., Al Mamun, A., Yuan, Y., Lu, Q., Xiong, J., Yang, S., ... & Wang, J. (2021). Acute spinal cord injury: Pathophysiology and pharmacological intervention. Molecular medicine reports, 23(6), 417. https://doi.org/10.3892/mmr.2021.12056

Zipser, C. M., Cragg, J. J., Guest, J. D., Fehlings, M. G., Jutzeler, C. R., Anderson, A. J., & Curt, A. (2022). Cell-based and stem-cell-based treatments for spinal cord injury: evidence from clinical trials. The Lancet Neurology, 21(7), 659-670.

Downloads

Published

2025-04-12

How to Cite

Emammer , E. K. ., Shauosh, D. A. M. ., Mohammed, R. T. ., & Hasan, F. J. . (2025). Effects of Pre-Surgery Physiotherapy on Walking Ability and Lower Extremity Strength in Spinal Cord Injury Patients: An Experimental Study. International Research Journal of Education and Innovation, 6(2), 1–33. Retrieved from https://irjei.com/index.php/irjei/article/view/222