Spinal Cord Injury and Disorders - VA Northeast Ohio Healthcare System
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VA Northeast Ohio Healthcare System

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Spinal Cord Injury and Disorders

Logo for Spinal Cord Injury at Cleveland VA Medical CenterMission and Vision

The Mission of the Louis Stokes Cleveland VA Medical Center Spinal Cord Injury System of Care (SCSC) program is to provide high quality, state of the art health care services to those veterans with spinal cord injury and/or disorders (SCI/D). 

We provide compassionate and ethical care based on current evidence and clinical standards. This mission is accomplished through a comprehensive health care delivery system that encompasses acute medical and surgical care, rehabilitation, patient and family education, psychological, social, and vocational care that spans from the initial injury to end of life. The professionals who serve in our SCSC program are dedicated to continuous professional development, research, and advocacy on behalf of our Veterans. Our vision is to be on the leading edge of spinal cord injury care and research.

Our Vision is to be on the leading edge of spinal cord injury care and research.

The Cleveland VA SCSC program is committed to continually improving the health care services we provide and maintaining a positive, caring, and helpful attitude toward all with whom we interact: patients, other employees, and visitors. We place the highest value upon both education and research and seek to expand our knowledge at all levels and in all areas of endeavor. We respect the autonomy of veterans and acknowledge the importance of including patients and their families in planning of care.

Accreditation

The acute SCI/D rehabilitation program and the SCI Outpatient Program at the Louis Stokes Cleveland VA Medical Center are certified by the Commission on Accreditation of Rehabilitation Facilities (CARF).

Access to Care

Veterans may access program services through referrals from VA facilities and clinics, the Department of Defense, community hospitals, and advocacy groups such as the Paralyzed Veterans of America. A designated SCI Coordinator handles all referrals. A formal SCI Registry is maintained by the SCSC. The Cleveland VA SCSC offers annual preventive health examinations and readmission based on the needs of the individual.

Services

General Admission, Continuing Stay, and Discharge Criteria

Admission Criteria for Acute Rehabilitation:

The Spinal Cord System of Care provides services for eligible persons with spinal cord injury and disorders, age 18 and over who have high and low tetraplegia, paraplegia, with complete or incomplete injuries. Veterans with comorbidities can be managed on the SCI unit as long as they are medically stable. The types of admissions to the Cleveland VA SCSC are as follows:

  • Active military duty personnel with acute SCI/D.
  • Veterans with new onset SCI/D in need of acute rehabilitation.
  • Veterans with existing SCI/D for acute medical and/or surgical problems.
  • Veterans with existing SCI/D for problem-oriented admissions.
  • Veterans with existing SCI/D for advanced rehabilitation programs.
  • Veterans with existing SCI/D for annual evaluation when outpatient evaluations are not feasible.

Typical diagnoses are:

  • Traumatic spinal cord injury.
  • High and Low Tetraplegia- complete or incomplete.
  • Paraplegia- complete of incomplete.
  • Intraspinal neoplasms resulting in neurologic deficits.
  • Vascular insults to the spinal cord.
  • Cauda equina syndrome producing neurologic deficits.
  • Inflammatory diseases of the spine or spinal cord resulting in neurologic deficits.
  • Demyelinating diseases of the spinal cord.
  • Unstable traumatic lesions of the spinal column to prevent neurologic deficits.
  • Degenerative spine disease resulting in neurologic deficits.
  • ALS for coordination of care.

Criteria for acute rehabilitation include the following:

  • Based on pre-admission assessment, the person’s functioning has potential to improve from intensive therapies.
  • The person needs 24-hour rehabilitative nursing care.
  • The patient is able to participate in an individualized rehabilitation program with increased intensity comprised of up to three hours of therapy per day, five days per week. Therapy will consist of at least two of the following: Physical Therapy, Occupational Therapy, Kinesiotherapy, Speech Therapy, and Recreation Therapy.
  • The person’s medical status is described as stable and free of known communicable disease that require isolation.
  • The person may require mechanical ventilation.
  • The person served may require acute rehabilitation to restore pre-morbid functional status after prolonged periods of inactivity associated with extended illnesses or secondary medical complications.
  • The person has an established discharge destination.

Continuing Stay Criteria for acute rehabilitation include:

  • The patient must remain medically stable.
  • The person participating in rehab remains willing to participate in the acute rehab process.
  • The person continues to show progress toward their long term acute rehab goals.

Discharge Criteria:

  • The individual has met the goals established on admission or during the course of rehabilitation.
  • Completion of discharge planning, such as providing necessary durable medical equipment and prosthetics; establishing a safe discharge destination and support system; preparing the person served and significant others through education; making follow-up appointments for medical, therapeutic or other required services; and communicating with referral sources and/or designated providers. 
  • The individual has reached maximum potential benefits for rehabilitation.
  • The patient is unwilling or unable to participate in the rehabilitation program. Patients unable to attend therapy for three consecutive days due to medical complications will be considered for discharge back to acute SCI medical service. Exceptions will be determined by the SCI/D Medical Director.
  • The patient experienced a significant medical, surgical, or psychological problem, which requires acute medical care or another service.
  • The Cleveland VA SCSC reserves the right to discharge individuals who violate organizational policies and procedures or who decline to participate in the agreed-upon plan of care.
  • The individual requests to be discharged from the program.

Follow-Up Care: Appointments will be set up for the Veteran for follow-up medical care before discharge. Dates and times of these appointments will be provided to the Veteran in writing.

Referral Criteria

Referrals to SCI Center should be made through local SCI spoke sites. For questions about referral process, admission criteria, or spoke site information, please contact the SCI Coordinator at 216-791-3800, ext. 64249.

  • Any veteran with a diagnosed spinal cord injury/disorder whose functioning has the ability to improve from therapies. 
  • Needs 24 hour rehabilitative nursing care.
  • The person has the capability to participate in an individualized rehab program with increased intensity comprised of up to three hours of therapy per day, five days per week.
  • The patient is medically stable and free of communicable diseases requiring isolation.
  • SCI Patients requiring acute rehab to restore function after prolonged debilitating medical course.
  • The person has an established discharge destination.

Inpatient

Inpatient Unit with 32 beds provides medical and rehabilitation services 24 hours per day, seven days per week.

Outpatient

Outpatient Clinic provides services including primary care, SCI specialty evaluations and rehabilitation therapies, interventions and consultations, nursing care, social work, psychological assessment and treatments, and other specialty area

Long Term Care (LTC)

The CARES Tower at the Cleveland VA Medical Center includes a 26 bed, Long Term Care Unit dedicated to Veterans with spinal cord inuries (SCI) who need long term, non-acute medical care. This unit includes several beds for SCI Veterans who need mechanical ventilation. For more information about Long Term Care, conhtact the SCI Coordinator at 216-791-3800, ext. 4249.

Rehabilitation Program

The SCI/D Center provides inpatient rehabilitation for Veterans with recent SCI injuries or other disorders that would benefit from intensive therapies. The acute rehabilitation program focuses on teaching Veterans the skills needed for daily living with an injury. The SCI/D center offers outpatient rehabilitation services as needed for Veterans with spinal cord injuries and disorders.

Vocational Rehabilitation

SCI/D Vocational Rehabilitation Services assists Veterans with accomplishing a variety of career-related goals, such as:

  • Determining a job goal by exploring interests, needs, work experience, abilities, and the local labor market.
  • Enrolling and funding for college or a training program.
  • Learning basic computer and Internet skills.
  • Finding a job or volunteer opportunity.
  • Understanding how working may impact VA, governement and employer benefits.
  • Understanding employment-related rights under the Americans with Disabilities Act (ADA)
  • Understanding how to request workplace accommodations.

For more information, please call the Vocational Rehabilitation counselor at 216-791-3800, ext. 66564.

Vocational Rehabilitation Schedule

All classes are held Thursdays at 2:30 p.m. to 3:30 p.m. For class locations, please call the Vocational Rehabilitation Counselor at 216-791-3800, ext. 66564.

Advanced Patient Education Classs and Schedule 

All classes are held the fourth Monday of each month from 1 p.m. - 2 p.m. For class locations, please call the SCI Coordinator at 216-791-3800, ext. 64249.


August 28, 2017: Abuse in SCI/D
September 25, 2017: Managing Personal Assistants

Telehealth Services

Telehealth is an exciting technology used to provide clinical care in circumstances where distance separates those receiving services and those providing services. By incorporating telehealth services into the treatment of Veterans with spinal cord injuries and disorders, the SCI/D Center can provide more timely access to providers and services, and reduce travel time and distance for Veterans, their families and caretakers. Using telehealth as a real-time technology to connect the Cleveland VA Medical Center to the sites and in some cases directly to the Veteran's home, VA provides a variety of services, including:

  • Spinal Cord Injury and Education.
  • Rehabilitation
  • Psychological support.
  • Spiritual support.
  • Primary care visits.

Current Telehealth programs offered:

MILO Passion - This is a six week telehealth intervention program to address barriers to sexuality associated with SCI/D.

Pain MILO - This is an 18-week telehealth intervention program designed specifically for SCI patients in which they learn pain management skills.

Project X - This is an 8 week telehealth intervention involving cinematherapy to teach coping skills for depression after SCI/D.

For more information about the SCI/D Unit Telehealth programs, please call the Telehealth Coordinator at 216-791-3800, ext. 66628.

Support groups offered:

Women's Group - This is a bi-monthly peer support group for women with disabilities attended by female Veterans from all over Ohio, Michigan and Pennsylvania by phone, video, or in person.

Outpatient Support Group - This weekly support group focus on disability advocacy projects and art therapy.

For more information on SCI/D Unit support groups, please call the Support Group Coordinator at 216-791-3800, ext. 64095.


Resources Patient Resources

  • Caregiver Support - Available through our tele-health program. It meets twice a month via a toll free call-in line. The group focuses on providing help and advice for caregivers of SCI/D Veterans. If you are interested in joining this group, please call SCI Psychology at 216-791-3800, ext. 66701 or ext. 64095.
  • Support Group - Meets on Wednesday from 3 p.m. to 4:30 p.m. in the SCI dining room. It is open to both inpatient and outpatients. If you are interested in being a aprt of this group, please contact SCI Coordinator at 216-791-3800, ext. 64249.
  • Weekly Patient Education - This series takes place every Thursday afternoon from 3 p.m. to 4 p.m. The focus of this education series is to provide basic information that everyone with a spinal cord injury should know. All Veterans with SCI and their caregivers are welcome.
  • Art Therapy Program - The Cleveland SCI Center has a new art therapy program for Veterans. For more information, please contact the SCI Recreation Therapist at 216-791-3800, ext. 3996.

Related Resources

Paralyzed Veterans of America (PVA) PVA SCI Publications

Amyotrophic Lateral Ssclerosis (ALS) Association

National Multiple Sclerosis (MS) Society

Christopher & Dana Reeve Foundation

Ready.gov

American Red Cross

Events and News

Wheelchair Games

The SCI/D Center participates annually in the National Veterans Wheelchair Games, the National Disabled Veterans Winter Sports Clinic, and the PVA Buckeye Chapter Wheelchair Games at Spire Institute in Geneva, Ohio. 

News

Art Therapy is an established mental health profession that uses the creative process of art making to improve and enhance the physical, mental, an emotional wellbeing of individuals of all ages. It is based on the belief that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce stress, increase self-esteem, and self awareness, and achieve insight.

Art therapy integrates the fields of human development, visual art (drawing, painting, sculpture, and other art forms), and creative process with models of counseling and psychotherapy. Art therapy is used with children, adolescents, adults, and older adults, groups, and families to access and treat the following: anxiety, depression, and other mental and emotional problems and disorders; mental illness; substance abuse and other addictions; family and relationship issues; abuse and domestic violence; social and emotional difficulties related to disability and illness; trauma and loss; physical, cognitive, and neurological problems; psychological difficulties related to medical illness.

Art therapists are masters level professionals who hold a degree in art therapy  or a related field. Educational requirements include: theories of art therapy, counseling, and psychotherapy; ethics and standards of practice; assessment and evaluation; individual, group, and family techniques; human and creative development; multicultural issues; research methods; and practicum experiences in clinical , community, and  or other settings. Art Therapists are skilled in the application of a variety of art modalities (drawing, painting, sculpture, and other media) for assessment. and treatment.

We are very pleased to have Denise Cooper, ATR-BC,PC from the Art Therapy Studio working with the SCI therapy and psychology departments for the past three months.  She interacts two half days per week with our SCI Veterans on a consultative basis.

SCI Events

National Disabled Veterans Winter Sports ClinicPVA Buckeye Chapter Wheelchair Games and National Veteran's Wheelchair Games information: Please contact SCI Recreation Therapy for dates and times of these adaptive sporting events, at 216-791-3800, ext. 63996.

Ongoing Events: project runway, fly tying, billiards, creative arts fair, community outings and much more. For information on how you can attend these events, please contact SCI Recreation Therapy at 216-791-3800, ext. 63996.

SCI Newsletters & Information

SCI/D May 2017 Newsletter


Current SCI Research Studies

Study of Neuromodulation
(1 year)-12/1/2016-12/1/2017       
Enrolling: Contact: Dr. S. Brose, ext. 63658

 

Automated Closed-loop Stimulation to Inhibit Neurogenic Bladder Overactivity
(5 years)- 1/1/2016-1/31/2020       
Enrolling: Contact: Dr. S. Brose, ext. 63658  

  

Translation of Afferent Stimulation for Inhibition of Bladder Incontinence
(1 year)                                               
Enrolling: Contact: Dr. S. Brose, ext. 63658
    


Intracortical Control of FES-restored Arm and Hand Function in People with SCI        
(5 years) -07/01/2014-04/30/2019 
This work aims to demonstrate the ability of an intracortical recording array to be used to control functional hand and arm movements using percutaneous FES in people with spinal cord injuries.                                        
Enrolling: Contact: Dr. S. Brose, ext. 63658     

 

High Frequency Spinal Cord Stimulation to Restore Cough
(4 years) -4/1/2014 – 3/31/2018           
The purpose of the work is to test a novel method of expiratory muscle activation: high frequency spinal cord stimulation to electrically activate the expiratory muscles, in an animal model.
Enrolling: Contact: Dr. S. Brose, ext. 63658     

Chronic Electrical Stimulation to Reduce Bladder Hyperreflexia after SCI
This project uses chronic patterned surface electrical stimulation of the genital nerve to inhibit bladder spasticity. The project uses intact spinal neural circuitry to improve continence and bladder capacity and reduce complications of bladder hyperreflexia.
Enrolling: Contact: Dr. S. Brose, ext. 63658    

 

The Early use of Non Invasive Positive Pressure Ventilation (NIPPV) and Survival in ALS
The aim of this study is to determine if earlier use of NIPPV will improve survival in veterans with ALS.                                      
Enrolling: Contact: Stephen Selkirk, MD, PhD, Frances McClellan, ext. 64731,

 

Utilizing Telehealth Technologies to Manage ALS
The aim of this study is to see if care provided via ALS is as effective as care provided in a face to face visit in the ALS Clinic.
Enrolling: Contact: Stephen Selkirk, MD. PhD, Brody Flynn, ext. 66628

 
Development of a personalized model for pressure for pressure ulcer prevention: biomarkers of muscle composition and resilience
The aim of the study is to develop a blood test that SCI patients can use to determine when they are high-risk for developing a pressure injury before any tissue breakdown occurs.
Enrolling: Contact: Kath Bogie, Jennifer Graebert, ext. 63036

 

Toward Personalized Pressure Ulcer Care Planning: Development of a Bioinformatics System for Individualized Prioritization of Clinical Practice Guideline
The aim of this study is to further develop a prototype model of environmental, social, and clinical factors for pressure ulcer risk in persons with SCI to support care plans for pressure ulcer prevention.
Enrolling: Contact: Kath Bogie, JC Seton, ext. 64236

 

 

 

Contact Info

Location

  • 10701 East Blvd.
    128(W)
    Cleveland, OH 44106

Contact Number(s)

  • 216-791-3800 Ext. 64249
  • 216-707-5936

Hours of Operation

  • Monday – Friday, 8:00 AM to 4:30 PM