Foreword

Perhaps there is no greater need for the concept of a team meeting or team rounds in rehabilitation than when we are confronted with the multitude of problems faced by the person who has sustained a catastrophic injury. This reality is particularly compelling in the case of spinal cord injury (SCI), especially in light of the comparative youth of such survivors and the need to maximize a quality of life for many years. At times, the physical, functional, behavioral, environmental, and social problems facing these patients appear insurmountable. Coupled with this reality is another inescapable fact. The time allocated for team meetings has often become constricted by a need to provide multiple services over less time, often with fewer resources. Accordingly, all team members being better positioned to understand their respective roles as well as the roles of others becomes an imperative.

In this context, students in health-related professions, as well as physicians from multiple specialties, are not optimally prepared to engage in dialogue with other team members. Indeed, some of us may never have learned how to do so. If there is a modicum of truth to these suppositions or if the image portrayed is remotely familiar to some, then a compendium that provides comprehensive information written for all rehabilitationists charged with the remarkable responsibility of optimizing the potential for the SCI survivor has long been needed. Edelle Field-Fote, PT, PhD., is passionate in her commitment to understand the mechanisms underlying SCI, exploiting the potential for inducing plasticity in the nervous system following such injuries, and tracking the evidence underlying the best practice amongst all members of the rehabilitation team. Her commitment to the SCI survivor to assure the best that rehabilitationists can offer is now approaching two decades. She believes fervently in the need to provide treatment to these patients through assembling the very best information at our disposal based upon critical reviews of the literature. Indeed, Spinal Cord Rehabilitation offers the most comprehensive treatment on this subject ever written for the rehabilitation community. She has painstakingly remained true to the philosophy underlying the Comprehensive Perspectives in Rehabilitation by assuring that all contributors have searched the literature to support the information provided, whether it be fundamental science or treatment approaches. The work is presented as an evidence-based approach to best practice more than a cookbook on how to treat. Thus the philosophy of the CPR series is preserved. Moreover, empiricism, while often important, plays a secondary role in the detailed accounts offered throughout this text.

Each chapter outlines what is to be accomplished within its pages, summarizes key points, and often is supplemented with relevant case histories, thus affording the reader some insights into how the presenter thinks. In fact, students and clinicians alike should realize that Dr. Field-Fote, by dint of shear effort complemented by a well-earned international respect, has assembled an uncontested "who's who" in SCI management. So, whether it is the student who needs to better understand multiple perspectives in the treatment of the SCI patient or the clinical specialist needing to catch up on the latest information within any aspect of patient management, the cast assembled herein would comprise a "dream team" that could easily surpass even the most accomplished in-hospital treatment team. The book is divided into three logical sections that first offer a contemporary overview of fundamental science and, as such, represents an excellent compilation of science related to SCI, expressed in a manner that is easily comprehensible to student and clinician alike. The second section addresses perspectives on treatment that are written with the intent to yield the maximal function achievable. Simply reading the specificity of the title for each chapter provides an expectation of the uniqueness of content. The last section approaches components that are so very important to the patient, but for which we sometimes claim ignorance or discomfort. Thus, participation in sports, relearning to drive, sexuality, and fertility are essential topics recognized by all of us, but which we are often unprepared to address or even understand.

There can be no greater contribution made by students of the rehabilitation process to the care of SCI patients than a proactive effort to absorb information from a myriad of issues that consume the thoughts of many of these patients. An appreciation for how other professionals manage essential aspects of care can have a profound impact on how your treatment plan is implemented and, more importantly, on the empathy you express toward your patients. 1To the experienced clinician whose time seems progressively more consumed by the rigors of administrative tasks at the expense of exercising the compassion and problem solving that directed their interests toward the SCI survivor, this book will foster the opportunity to absorb important and documented information. This opportunity can certainly occur within the treatment environment, but, more importantly, outside of it, when time permits reflection on the glorious commitment you have made to these courageous individuals.