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  • Understanding SCI
    • Aging
      • Bladder changes with age
        • How does aging affect the bladder with SCI?
      • Bowel changes with age
        • How does aging with SCI affect the bowel?
      • Pain and aging
        • How does aging affect pain after SCI?
      • Staying physically active
        • How does aging affect physical activity after SCI?
    • Spinal Cord Injury
      • Spinal cord anatomy
        • What is the spine?
        • What is the spinal cord?
        • How does the spinal cord work?
      • Injury types and causes
        • What is non-traumatic SCI?
        • What causes non-traumatic SCI?
        • Who gets non-traumatic SCI?
        • How does non-traumatic SCI present?
        • How is non-traumatic SCI treated?
        • What causes spinal cord injury?
      • Injury levels and classification
        • What are “complete” and “incomplete” spinal cord injuries?
        • What is the “neurological level of injury”?
        • What is the International Standards for Neurological Classification of Spinal Cord Injury exam?
        • What are “upper” and “lower” motor neuron injuries?
      • Changes after injury and early recovery
        • What is spinal cord injury?
        • What are the signs and symptoms of spinal cord injury?
        • How common is spinal cord injury?
    • Understanding Health Care
      • Emergency and hospital care
        • What is “acute care”?
        • What happens in acute care right after a spinal cord injury?
        • What are the early symptoms of spinal cord injury?
        • How are spinal cord injuries diagnosed?
        • What emergency treatments are used after spinal cord injury?
        • What complications can develop after a spinal cord injury?
        • What other health issues may be present in the hospital?
        • What emotional reactions do people have after an SCI?
        • What are the roles of the health providers in acute care?
        • What is the equipment at the bedside for?
        • How long do people stay in the acute care hospital?
        • Where do people go after acute care?
      • Understanding rehabilitation and the care team
        • What is rehabilitation?
        • What types of rehabilitation are there?
        • What testing is done in rehabilitation?
        • Why is goal setting important in rehabilitation?
        • What activities may happen in rehabilitation?
        • How are medical problems addressed in rehabilitation?
        • What is done to support adjustment and coping during rehab?
        • What mobility and independent living activities are done in rehab?
        • How do you plan for return to community living in rehab?
        • Who works in rehabilitation?
        • How long do people stay in rehabilitation?
        • Where do people go after rehabilitation?
      • Rehabilitation length of stay and discharge
        • The SCI care pathway
        • Typical rehabilitation length of stay around the world
        • How has rehabilitation length of stay changed over the years?
        • Injury/demographic factors influencing rehab LOS
        • Healthcare system factors determining rehab LOS
        • Socio-Cultural factors determining rehab LOS
        • Does greater rehab length of stay improve outcomes?
      • Working with a primary care provider
        • What is a primary care provider?
        • When should I see my primary care provider?
        • When do I need to go to urgent care or emergency?
        • How do I prepare for appointment?
        • What should I ask my primary care provider to check?
        • How can my PCP improve their knowledge of SCI?
    • Research
      • Understanding study designs
        • What types of research studies are there?
      • Understanding results and strength of evidence
        • What is “research evidence”?
        • Why do we need research evidence?
        • How do you determine the quality of the evidence?
        • What are the limitations of research evidence?
        • Making decisions using research evidence?
      • Applying research to care decisions
        • Spinal cord injury research
        • What if there is no research on something?
  • Body & Function
    • Bladder Health
      • How the bladder changes after SCI
        • How does the bladder work?
        • How does the bladder change after SCI?
        • What are “spastic” and “flaccid” bladder?
        • Urinary catheters
      • Bladder assessment and monitoring
        • How are bladder changes diagnosed?
      • Bladder routines and catheters
        • How are bladder changes managed?
        • Reflex voiding
        • What are urinary catheters?
        • Why are urinary catheters used?
        • What types of catheterization are there?
        • How effective are urinary catheters for managing bladder problems after SCI?
      • Medications, injections and surgery
        • Medications and injections
        • Bladder surgery and stents for bladder management
        • Other treatments
      • Urinary infections and other complications
        • What other complications are related to bladder changes?
        • What are the risks and side effects of using urinary catheters?
        • What are urinary tract infections?
        • What do urinary tract infections look and feel like?
        • Why do urinary tract infections happen?
        • How are urinary tract infections diagnosed?
        • How are urinary tract infections treated?
        • What can be done to prevent urinary tract infections?
    • Bone Health
      • Bone changes and osteoporosis
        • What is osteoporosis?
        • What is osteoporosis after SCI?
        • Why does osteoporosis happen after SCI?
        • Who is at risk for osteoporosis and fractures after SCI?
        • Bisphosphonates
      • Risk factors, screening and diagnosis
        • How is osteoporosis after SCI diagnosed and measured?
      • Preventing bone loss and fractures
        • How is osteoporosis after SCI treated?
        • Physical therapy
      • Osteoporosis treatment options
    • Bowel Health
      • How the bowel changes after SCI
        • How does the bowel work?
        • How does bowel function change after SCI?
        • What are “spastic” and “flaccid” bowel?
        • What bowel problems can happen after SCI?
        • Hands-on bowel techniques
        • Diet and fluids
      • Bowel assessment and complications
        • How are bowel changes diagnosed?
      • Building a bowel routine
        • What is a bowel routine?
      • Medications, procedures and surgery
        • Medications and suppositories
        • Other treatments
    • Breathing
      • How breathing changes after SCI
        • How does the respiratory system work?
        • How does an SCI affect the respiratory system?
        • What secondary respiratory issues occur with acute SCI?
      • Respiratory infections and complications
        • What happens to the respiratory system after SCI?
        • What is the immune system?
        • What happens to the immune system after SCI?
        • Why are people with SCI at higher risk for respiratory infections?
        • What infectious respiratory conditions should I be aware of?
        • What can you do to prevent infectious respiratory conditions?
        • What are the risks and side effects of using inspiratory muscle training?
        • How can respiratory complications be managed acutely?
      • Breathing exercises and assisted techniques
        • What is ‘inspiratory muscle training’?
        • How is inspiratory muscle training done?
        • Why is inspiratory muscle training used?
        • Are there restrictions or precautions for using inspiratory muscle training?
        • Does inspiratory muscle training work for people with SCI?
      • Equipment, ventilation and other treatments
        • How can mechanical ventilation be used to help breathing?
        • How are respiratory problems managed and prevented long term?
        • What is the emerging research on processes to help with breathing?
    • Skin Health
      • Understanding pressure injuries
        • What are pressure injuries?
        • Why is it important to know about pressure injuries?
      • Recognizing and assessing skin damage
        • What are the stages of pressure injuries?
        • How are pressure injuries diagnosed?
      • Daily prevention and pressure relief
        • What can be done to prevent pressure injuries?
        • How can I find the time and resources to do prevention?
      • Seating and pressure mapping
        • What is pressure mapping?
        • Why is pressure mapping used?
        • How is pressure mapping done?
        • What are the limitations to the use of pressure mapping?
        • How effective is pressure mapping?
      • Wound care and treatment options
        • What causes pressure injury?
        • How are pressure injuries treated?
    • Spasticity
      • Understanding spasticity and its triggers
        • What is spasticity?
        • What does spasticity feel or look like?
        • Why does spasticity happen?
      • Assessment and effects on daily life
        • How is spasticity diagnosed?
      • Physical approaches and self-management
        • Should spasticity be treated?
        • How is spasticity treated?
      • Medications, injections and surgery
  • Staying Healthy
    • Autonomic and Cardiovascular Health
      • Autonomic dysreflexia: signs and emergency care
        • What are the signs and symptoms of autonomic dysreflexia?
      • Autonomic dysreflexia: triggers and prevention
        • What is autonomic dysreflexia?
        • What can happen if autonomic dysreflexia goes untreated?
        • What can trigger autonomic dysreflexia?
        • Why does autonomic dysreflexia happen?
        • How is autonomic dysreflexia treated?
        • How can autonomic dysreflexia be prevented?
      • Low blood pressure: symptoms and assessment
        • What is orthostatic hypotension?
        • Who is at risk of experiencing orthostatic hypotension after SCI?
        • Why does orthostatic hypotension happen?
        • How is orthostatic hypotension diagnosed?
      • Low blood pressure: management and abdominal binders
        • What are abdominal binders?
        • What types of abdominal binders are there?
        • Why are abdominal binders used?
        • Are abdominal binders safe to use?
        • How do you put on abdominal binders?
        • What medications are used to treat orthostatic hypotension?
        • What other treatment options are there?
    • Mental Health
      • Recognizing depression
        • What is depression?
        • What are the signs and symptoms of depression?
        • How does depression affect people with SCI?
      • Assessment and getting support
        • How is depression diagnosed?
      • Psychological and lifestyle approaches
        • What causes depression?
        • How is depression after SCI treated?
      • Medications and other treatments
    • Nutrition
      • Dietary fibre and bowel health
        • What is dietary fibre?
        • Why is fibre important in spinal cord injury?
        • How much fibre do we get?
        • How much fibre should you get?
        • How do you safely increase dietary fibre intake?
        • How do you choose the right foods?
      • Understanding the gut microbiome
        • What is the microbiome?
        • What happens when the gut microbiome is out of balance?
        • What changes occur in the gut microbiome after SCI?
        • What changes occur to the bladder microbiome after SCI?
        • What affects the gut microbiome?
      • Food, supplements and microbiome treatments
        • What treatments have a positive effect on the gut microbiome in people with SCI?
    • Pain
      • Pain types, causes and assessment
        • Why is it important to know about pain after SCI?
        • What types of pain are there?
        • How does pain happen?
        • How is pain measured?
      • Pain management options
        • How is pain after SCI treated?
        • What medications are used for pain after SCI?
        • What physical treatments are used for pain after SCI?
        • What psychological and mind-body therapies are used for pain after SCI?
        • How is surgery used for pain after SCI?
      • Shoulder pain and injury prevention
        • Is shoulder pain common?
        • Shoulder anatomy
        • What are the different classifications of pain?
        • What are the risk factors for developing shoulder pain?
      • Shoulder assessment and treatment
        • What is involved in a shoulder assessment?
        • How can shoulder injuries be prevented and treated?
    • Sleep
      • Understanding sleep-disordered breathing
        • What is sleep disordered breathing?
        • Why is sleep disordered breathing common after SCI?
      • Symptoms, risks and diagnosis
        • What are the symptoms of sleep apnea?
      • Sleep and breathing treatment options
        • What treatment is available for sleep disordered breathing
    • COVID-19
      • SCI-specific information — historical guidance
        • Are you at a higher risk for COVID-19 because of your SCI?
        • What are the precautions you can take to prevent exposure?
        • How can you keep your equipment clean?
        • What can you do to ensure you are interacting safely?
        • When should you seek medical attention, and what do your healthcare providers need to know?
      • Caregiver information — historical guidance
        • Hygiene and equipment
        • What if you get sick?
        • Resources for caregivers
      • Mental health and social connection — historical guidance
        • Looking after your psychological and mental health
        • Coping with worry during global uncertainty
        • What is social isolation, and what are its potential effects?
        • When should I seek help?
        • What can I do to maintain good health during the pandemic?
  • Movement & Equipment
    • Movement and Exercise
      • Benefits and types of physical activity
        • What are the benefits of exercise after SCI?
        • What are ways I can exercise after SCI?
        • What are the exercise guidelines?
        • How can I adapt exercises?
        • What should I be cautious of when exercising?
      • Exercise guidelines and getting started
        • How were the exercise guidelines developed?
        • What are the exercise guidelines for adults with SCI?
        • What are cardiometabolic health, cardiorespiratory fitness, and muscle strength?
        • The exercise guideline details
      • Adapted sports and equipment
        • Why be physically active after SCI?
        • What are adapted sports?
        • What types of cycling and pushing sports are there?
        • What adapted court sports are available?
        • What adapted winter sports are available?
        • What water sports are available?
      • Supported standing: benefits, equipment and safety
        • Why is standing used as a therapy?
        • What types of equipment are used for standing?
        • How is standing done?
        • Is supported standing safe?
        • Does supported standing work?
    • Walking and Mobility
      • Walking rehabilitation and treadmill training
        • What is body weight supported treadmill training?
        • How is body weight supported treadmill training done?
        • Are there restrictions or precautions for body weight supported treadmill training?
        • Are there other limitations to using this treatment?
        • Does body weight supported treadmill training improve walking after incomplete SCI?
        • Can body weight supported treadmill training cause stepping after complete SCI?
      • Robotic exoskeletons: use and suitability
        • What are robotic exoskeletons?
        • What is the history behind robotic exoskeletons?
        • What types of exoskeletons are available?
        • What are exoskeletons used for?
        • Are there restrictions or precautions for using robotic skeletons?
        • How does walking with an exoskeleton change over time?
        • What influences walking speed and skill acquisition when using an exoskeleton?
      • Benefits, limitations and safety of walking devices
        • What are the risks and side effects of body weight supported treadmill training?
        • What are the risks and considerations for using an exoskeleton?
        • Can I get exercise benefits from walking in an exoskeleton
        • What evidence is there for using an exoskeleton in the community?
    • Wheelchairs and Equipment
      • Assessment, selection and wheelchair provision
        • What are wheeled mobility devices?
        • What types of wheeled mobility devices are there?
        • How is a wheeled mobility device selected?
        • Why is device selection and set-up important?
        • What is the wheelchair provision process?
      • Manual wheelchairs
        • Who can use a manual wheelchair?
        • What are the components of a manual wheelchair?
        • What are adjustments I can make to the set-up of my wheelchair?
        • What are health concerns related to manual wheelchair use?
      • Powered mobility
        • What are power wheelchairs?
        • What types of power wheelchairs are there?
        • What parts of a power wheelchair should I know about?
        • What impacts battery life?
        • What other powered mobility devices are there?
      • Power assist and propulsion devices
        • What are wheelchair propulsion assist devices?
        • What are the benefits of using a propulsion assist device?
        • What are the risks associated with using a propulsion assist device?
        • What should I consider when contemplating a propulsion assist device?
        • What are the options for non-powered propulsion assist devices?
        • What are the options for powered propulsion assist devices?
      • Seating and positioning
        • What is a wheelchair seating assessment?
        • Why is proper seating important?
        • Why are cushions important?
        • How can a cushion help redistribute pressure?
        • What kinds of cushions are there?
        • What aspects of a backrests can be modified?
        • Why are footrests important?
        • Why are arm rests important?
        • What accessories are used for seating?
      • Wheelchair maintenance
        • Why is wheelchair maintenance important?
        • What equipment do I need to maintain my wheelchair
        • What maintenance and checks should be done for a manual wheelchair?
        • What maintenance should be done for a power wheelchair?
        • What are common issues that arise with manual wheelchair use?
        • What are some simple repairs I can do?
  • Daily Life
    • Community Living
      • Housing and accessibility
        • Why is housing important?
        • What factors influence where I will live after the hospital?
        • How do I make my house accessible?
        • What renovations can I make to my home to make it accessible?
        • What are low-cost methods of making my home more accessible?
      • Driving and vehicle adaptations
        • Why is driving after SCI beneficial?
        • How do I know if I can drive?
        • What does a driving assessment look like?
        • How will I learn to drive?
        • What kind of vehicle can I drive?
        • What kinds of adaptations are available for my vehicle?
        • What are some considerations when using and buying an adapted vehicle?
      • Travel planning and accessibility
        • What should I consider when selecting a trip destination?
        • What are considerations for finding accommodations?
        • What are considerations for transportation?
        • What should I pack for my trip?
        • Air travel: Before the flight
        • Air travel: At the airport
        • Air travel: Boarding the plane
        • Air travel: During the flight
        • Air travel: Arriving at your destination
        • The role of mobile apps
      • Quality of life and community experiences
        • What is quality of life?
        • Does spinal cord injury impact quality of life?
        • What can increase quality of life for people with SCI?
        • What can decrease quality of life for people with SCI?
        • Does accessibility impact quality of life?
    • Reproductive Health
      • Pregnancy planning and care
        • Can I get pregnant after SCI?
        • What should I know before pregnancy?
        • What are the potential risks during pregnancy?
        • Should I get an epidural?
        • Do I need a caesarean section?
        • What should I expect after my pregnancy?
      • Labour, delivery and recovery
        • What should I expect during childbirth?
        • Do I have to give birth at a large hospital?
      • Breastfeeding and support
        • Why is breastfeeding recommended?
        • Can I breastfeed?
        • What are the challenges during breastfeeding?
        • Will the level of my spinal cord injury affect my ability to breastfeed?
        • How will I be able to get my baby to latch effectively?
        • What specific positions and aids can I use to help me with breastfeeding?
        • What should I do if I cannot produce enough milk?
        • What breast health issues should I be aware of?
        • Can I stay on my SCI medications and breastfeed at the same time?
        • Am I at risk for autonomic dysreflexia (AD) during breastfeeding?
        • Will I have difficulty bonding with my baby if I have breastfeeding problems?
        • Am I more at risk for postpartum depression after delivery of my child?
        • Where can I find additional support and information?
        • Contributors
        • Acknowledgements
      • Parenting experiences
    • Sexual Health
      • Sexual changes and relationships
        • What is “sexual health”?
        • What is “sex”?
        • How do the sex organs work?
        • What changes after SCI?
        • What other considerations affect sexual health?
        • What other techniques may be used to improve sexual health?
      • Sexual function and assessment
        • What is a sexual health assessment like?
      • Treatment options for men
        • What medical treatments are available for men?
      • Treatment options for women
        • What medical treatments are available for women?
  • Treatments & Recovery
    • Medications
      • Baclofen: uses, delivery and evidence
        • What is baclofen?
        • How is baclofen used?
        • Are there restrictions or precautions for using baclofen?
      • Baclofen: risks and treatment decisions
        • What are the risks and side effects of using baclofen?
      • Botulinum toxin: uses, treatment and evidence
        • What is botulinum toxin?
        • How is botulinum toxin treatment done?
        • How does botulinum toxin work?
        • Are there restrictions or precautions for using botulinum toxin?
        • Is botulinum toxin effective?
      • Botulinum toxin: risks and treatment decisions
        • What are the risks and side effects of botulinum toxin?
    • Alternative Medicine
      • Acupuncture: use, evidence and safety
        • What is acupuncture?
        • How is acupuncture done?
        • How does acupuncture work?
        • Are there restrictions or precautions for using acupuncture
        • What are the risks and side effects of using acupuncture?
        • Is acupuncture effective for treating the symptoms of SCI?
      • Cannabis: forms, uses and evidence
        • What is cannabis?
        • What are cannabinoids?
        • What is the difference between medical and recreational cannabinoids?
        • What are the ways cannabinoids can be used?
        • What is the suggested dosing of cannabis?
        • What are cannabinoids used for after spinal cord injury?
      • Cannabis: risks, interactions and access
        • What are the risks and side effects of cannabis?
    • Neuromodulation
      • Functional electrical stimulation: uses and equipment
        • What is “functional electrical stimulation” (FES)?
        • How is FES done?
        • Are there restrictions or precautions for FES?
        • Does FES improve strength and fitness after SCI?
      • Functional electrical stimulation: evidence and safety
        • How does FES work?
        • What are the risks and side effects of FES?
        • Does FES help with other complications of SCI?
      • Epidural stimulation: procedure, evidence & safety
        • What is epidural stimulation?
        • How does epidural stimulation work?
        • How are epidural stimulation electrodes implanted?
        • Are there restrictions or precautions for using epidural stimulation?
        • What are the risks and side effects of epidural stimulation?
        • Epidural stimulation: Body Functions & Regulation
        • Epidural stimulation: Movement & Mobility
        • Epidural stimulation: Muscle Function & Physical Health
        • Costs and availability of epidural stimulation
      • TENS: use, evidence and safety
        • What is “transcutaneous electrical nerve stimulation” (TENS)?
        • How is TENS used?
        • How does TENS work?
        • Are there restrictions or precautions for using TENS?
        • What are the risks and side effects of using TENS?
        • Is TENS effective for treating pain and spasticity after SCI?
    • Surgery
      • Nerve transfer: eligibility and planning
        • What is nerve transfer surgery?
        • Why are nerve transfers done?
        • Who is suitable for a nerve transfer?
        • What is the process for a nerve transfer?
        • How do nerve transfers compare to tendon transfers?
        • What are the limitations of nerve transfers?
        • Are nerve transfers effective?
        • Lived experiences of nerve transfer
      • Nerve transfer: procedure and rehabilitation
      • Nerve transfer: results, risks and experiences
        • What are the risks of nerve transfers?
    • Repair and Recovery
      • Neuroprotection: approaches, evidence and risks
        • What is neuroprotection?
        • What causes secondary injury?
        • What types of neuroprotection are there?
        • Why is it so difficult to find effective neuroprotective treatments?
      • Stem cells: approaches, evidence and risks
        • What are stem cells?
        • What are stem cells used for?
        • How can stem cells be used for SCI?
        • What stem cell research has been done in human SCI populations?
      • Accessing experimental treatments and making decisions
        • What are the risks and considerations of using stem cells?
        • Should I participate in a stem cell clinical trial?
  • About SCIRE
  • Community Stories
  • Resources
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  5. Welcome Message from Rick Hansen
Welcome Message from Rick Hansengssi-scire-c2026-11-07T16:52:00+00:00
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Welcome Message from Rick Hansen

Monday July 31, 2017

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