Individuals with SCI experience a wide range of secondary complications including pain, urinary tract infections, bowel problems and spasticity. Unfortunately, standard medical care is not always successful in managing these complications (Pannek et al., 2015). As a result, many patients turn to complementary and alternative medicines (CAMs) (Pannek et al., 2015). In a recent study, it was found that 19.1% of SCI patients had used CAM, with pain being the most common reason for use (86.4%) (Carlson et al., 2006).
Acupuncture is an ancient Chinese therapy that has been practiced for more than 4000 years to prevent and treat diseases (Lee & Liao 1990; Fan et al., 2018). When a patient undergoes acupuncture, a hair-thin needle is inserted into an acupoint and manipulated manually or electrically (Fan et al., 2018). To date, more than 361 acupoints, which form a network of 14 channels (meridians) have been identified. It has been speculated that acupuncture therapy, when applied to acute SCI, assists in minimizing cord shrinkage and spares ventral horn neurons (Politis & Korchinski 1990; Ran et al., 1992; Tsay 1974; Wu 1990). However, there are few clinical studies to support the therapeutic efficacy of acupuncture in SCI.
Trager psychophysical integration (Trager) is a form of bodywork and movement re-education developed by Milton Trager. It is based off the theory that the brain, through the nervous system, contributes to pain by maintaining muscles and other soft tissues in a chronically contracted and inflamed position (Dyson-Hudson et al., 2001). Trager therapy aims to induce relaxation and release tension through the use of gentle, rhythmic, non-intrusive movements and touch. Patients are taught to identify and correct movement patterns that may lead to pain and as a result it is often considered a form of movement re-education (Dyson-Hudson et al., 2001). Interestingly, several case studies found Trager improves range of motion and decreases pain in a number of musculoskeletal disorders (Blackburn, 2003). However, there are few clinical studies reporting the therapeutic efficacy of Trager in SCI.
The methodological details and results from two studies investigating acupuncture and Trager as a rehabilitative therapy for spinal cord injured individuals are listed in Table 26.