This analytic autoethnography explores the rehabilitation journey of a spinal cord injury (SCI) survivor who is also a movement scientist. Drawing on personal bodily experiences, daily logs, and critical reflections over five years, the study analyzes how standardized rehabilitation protocols may fail to address individual needs. Three main themes emerged: the need for personalized stretching protocols that consider postural variations; overlooked biomechanical and procedural limitations in robotic gait therapy; and the underutilization of cardiovascular training despite its potential in chronic SCI management. These insights, grounded in both lived experience and movement science, point to systemic blind spots in SCI rehabilitation. By combining subjective embodiment with theoretical reasoning, this study contributes practitioner-informed critiques that may support more adaptive and patient-centered approaches in neurological rehabilitation practice.
AlashramA. R.AnninoG.PaduaE. (2021). Robot-assisted gait training in individuals with spinal cord injury: A systematic review for the clinical effectiveness of Lokomat. Journal of Clinical Neuroscience, 91, 260–269. https://doi.org/10.1016/j.jocn.2021.07.019
AstorinoT. A.HicksA. L.BilzonJ. L. (2021). Viability of high intensity interval training in persons with spinal cord injury—A perspective review. Spinal Cord, 59(1), 3–8. https://doi.org/10.1038/s41393-020-0492-9
4.
AstorinoT. A.SchubertM. M. (2018). Changes in fat oxidation in response to various regimes of high intensity interval training (HIIT). European Journal of Applied Physiology, 118(1), 51–63. https://doi.org/10.1007/s00421-017-3756-0
5.
AstorinoT. A.ThumJ. S. (2018). Interval training elicits higher enjoyment versus moderate exercise in persons with spinal cord injury. The Journal of Spinal Cord Medicine, 41(1), 77–84.
6.
BaeY. H.KoY. J.ChangW. H.LeeJ. H.LeeK. B.ParkY. J.HaH. G.KimY. H. (2014). Effects of robot-assisted gait training combined with functional electrical stimulation on recovery of locomotor mobility in chronic stroke patients: A randomized controlled trial. Journal of Physical Therapy Science, 26(12), 1949–1953. https://doi.org/10.1589/jpts.26.1949
7.
BaileyK. A.GammageK. L.van IngenC.DitorD. S. (2016). Managing the stigma: Exploring body image experiences and self-presentation among people with spinal cord injury. Health Psychology Open, 3(1). https://doi.org/10.1177/2055102916650094
8.
BaileyK. A.GammageK. L.van IngenC.DitorD. S. (2017). “My body was my temple”: A narrative revealing body image experiences following treatment of a spinal cord injury. Disability and Rehabilitation, 39(18), 1886–1892. https://doi.org/10.1080/09638288.2016.1211753
9.
BalthazaarS. J.HodgkissD. D.ChiouS. Y.LucasS. J.StathiA.KallaM.OsmanA. E. F.BudithiS. C.KumarN.ChowdhuryJ. R.NightingaleT. E. (2025). ‘Time is of the essence’: Upper-body aerobic exercise to improve cardiovascular health during inpatient rehabilitation within the first year following spinal cord injury–protocol for a randomised clinical trial. BMJ Open, 15(4), Article e089868. https://doi.org/10.1136/bmjopen-2024-089868
10.
BerschI.AlbertyM.FridénJ. (2022). Robot-assisted training with functional electrical stimulation enhances lower extremity function after spinal cord injury. Artificial Organs, 46(10), 2009–2014. https://doi.org/10.1111/aor.14386
11.
BinL.WangX.JiatongH.DonghuaF.QiangW.YingchaoS.YimingM.YongM. (2023). The effect of robot-assisted gait training for patients with spinal cord injury: A systematic review and meta-analysis. Frontiers in Neuroscience, 17, Article 1252651. https://doi.org/10.3389/fnins.2023.1252651
12.
BresnahanJ. J.FarkasG. J.ClaseyJ. L.YatesJ. W.GaterD. R. (2019). Arm crank ergometry improves cardiovascular disease risk factors and community mobility independent of body composition in high motor complete spinal cord injury. The Journal of Spinal Cord Medicine, 42(3), 272–280. https://doi.org/10.1080/10790268.2017.1412562
13.
BrurokB.HelgerudJ.KarlsenT.LeivsethG.HoffJ. (2011). Effect of aerobic high-intensity hybrid training on stroke volume and peak oxygen consumption in men with spinal cord injury. American Journal of Physical Medicine & Rehabilitation, 90(5), 407–414. https://doi.org/10.1097/PHM.0b013e31820f960f
14.
CarlsonK. F.WiltT. J.TaylorB. C.GoldishG. D.NiewoehnerC. B.ShamliyanT. A.KaneR. L. (2009). Effect of exercise on disorders of carbohydrate and lipid metabolism in adults with traumatic spinal cord injury: Systematic review of the evidence. The Journal of Spinal Cord Medicine, 32(4), 361–378. https://doi.org/10.1080/10790268.2009.11754465
15.
ChiouS. Y.ClarkeE.LamC.HarveyT.NightingaleT. E. (2022). Effects of arm-crank exercise on fitness and health in adults with chronic spinal cord injury: A systematic review. Frontiers in Physiology, 13, Article 831372. https://doi.org/10.3389/fphys.2022.831372
16.
ChoiW. (2022). Effects of robot-assisted gait training with body weight support on gait and balance in stroke patients. International Journal of Environmental Research and Public Health, 19(10), Article 5814. https://doi.org/10.3390/ijerph19105814
17.
CliftonS. (2014). Grieving my broken body: An autoethnographic account of spinal cord injury as an experience of grief. Disability and Rehabilitation, 36(21), 1823–1829. https://doi.org/10.3109/09638288.2013.872202
18.
DenzinN. K.LincolnY. S. (2005). The Sage handbook of qualitative research (3rd ed.). Sage.
19.
DeshmukhV. (2019). Health benefits of stretching. Aayushi International Interdisciplinary Research Journal, 6(5), 123–126.
20.
EllisC.BochnerA. P. (2000). Autoethnography, personal narrative, reflexivity: Researcher as subject. In DenzinN. K.LincolnY. S. (Eds.), Handbook of qualitative research (2nd ed., pp. 733–768). Sage.
21.
EsquenaziA.TalatyM.JayaramanA. (2017). Powered exoskeletons for walking assistance in persons with central nervous system injuries: A narrative review. PM&R, 9(1), 46–62. https://doi.org/10.1016/j.pmrj.2016.07.534
22.
FangC. Y.TsaiJ. L.LiG. S.LienA. S. Y.ChangY. J. (2020). Effects of robot‐assisted gait training in individuals with spinal cord injury: A meta‐analysis. BioMed Research International, 2020(1), Article 2102785. https://doi.org/10.1155/2020/2102785
23.
FarrowM.MaherJ.DeereR.SpellanzonB.WilliamsS.ThompsonD.BilzonJ. L. (2024). Effect of high‐intensity interval training on cardiometabolic component risks in persons with paraplegia: Results of a randomized controlled trial. Experimental Physiology, 109(8), 1253–1266. https://doi.org/10.1113/EP091803
24.
GlinskyJ. V.HarveyL. A. (2024). Physiotherapy management of people with spinal cord injuries: An update. Journal of Physiotherapy, 70(4), 256–264. https://doi.org/10.1016/j.jphys.2024.09.008
25.
HandleryR.HandleryK.KahlD.KoonL.ReganE. W. (2024). High intensity functional training for people with spinal cord injury & their care partners. Spinal Cord, 62(7), 357–366. https://doi.org/10.1038/s41393-024-00977-8
26.
HarnishC. R.DanielsJ. A.CarusoD. (2017). Training response to high-intensity interval training in a 42-year-old man with chronic spinal cord injury. The Journal of Spinal Cord Medicine, 40(2), 246–249. https://doi.org/10.1080/10790268.2015.1136783
27.
HarveyL.HerbertR. (2002). Muscle stretching for treatment and prevention of contracture in people with spinal cord injury. Spinal Cord, 40(1), 1–9. https://doi.org/10.1038/sj.sc.3101241
28.
HarveyL.LinC. W.GlinskyJ.De WolfA. (2009). The effectiveness of physical interventions for people with spinal cord injuries: A systematic review. Spinal Cord, 47(3), 184–195. https://doi.org/10.1038/sc.2008.100
29.
HarveyL. A.GlinskyJ. A.KatalinicO. M.BenM. (2011). Contracture management for people with spinal cord injuries. NeuroRehabilitation, 28(1), 17–20. https://doi.org/10.3233/NRE-2011-0627
30.
HarveyL. A.KatalinicO. M.HerbertR. D.MoseleyA. M.LanninN. A.SchurrK. (2017). Stretch for the treatment and prevention of contracture: An abridged republication of a Cochrane Systematic Review. Journal of Physiotherapy, 63(2), 67–75. https://doi.org/10.1016/j.jphys.2017.02.014
31.
KrassioukovA. V.CurrieK. D.HubliM.NightingaleT. E.AlrashidiA. A.RamerL.EngJ. J.GinisK. A. M.MacDonaldM. J.HicksA.DitorD.OhP.VerrierM. C.CravenB. C. (2019). Effects of exercise interventions on cardiovascular health in individuals with chronic, motor complete spinal cord injury: Protocol for a randomised controlled trial [Cardiovascular Health/Outcomes: Improvements Created by Exercise and education in SCI (CHOICES) Study]. BMJ Open, 9(1), Article e023540. https://doi.org/10.1136/bmjopen-2018-023540
32.
LaguT.SchrothS. L.HaywoodC.HeinemannA.KesslerA.MorseL.KhanS. S.KershawK. N.NashM. S. (2023). Diagnosis and management of cardiovascular risk in individuals with spinal cord injury: A narrative review. Circulation, 148(3), 268–277. https://doi.org/10.1161/CIRCULATIONAHA.123.064859
33.
LindeM. B.WebbK. L.VeithD. D.MorkebergO. H.GillM. L.Van StraatenM. G.LaskowskiE. R.JoynerM. J.BeckL. A.ZhaoK. D.WigginsC. C.GarlangerK. L. (2023). At-home high-intensity interval training for individuals with paraplegia following spinal cord injury: A pilot study. medRxiv. https://doi.org/10.1101/2023.06.21.23291711
34.
Martin GinisK. A.HicksA. L.LatimerA. E.WarburtonD. E. R.BourneC.DitorD. S.GoodwinD. L.HayesK. C.McCartneyN.McIlraithA.PomerleauP.SmithK.StoneJ. A.WolfeD. L. (2011). The development of evidence-informed physical activity guidelines for adults with spinal cord injury. Spinal Cord, 49(11), 1088–1096. https://doi.org/10.1038/sc.2011.63
35.
Martin GinisK. A.van der ScheerJ. W.Latimer-CheungA. E.BarrowA.BourneC.CarruthersP.BernardiM.DitorD. S.GaudetS.de GrootS.HayesK. C.HicksA. L.LeichtC. A.LexellJ.MacalusoS.MannsP. J.McBrideC. B.NoonanV. K.PomerleauP.Goosey-TolfreyV. L. (2018). Evidence-based scientific exercise guidelines for adults with spinal cord injury: An update and a new guideline. Spinal Cord, 56(4), 308–321. https://doi.org/10.1038/s41393-017-0017-3
36.
McleodJ. C.DianaH.HicksA. L. (2020). Sprint interval training versus moderate-intensity continuous training during inpatient rehabilitation after spinal cord injury: A randomized trial. Spinal Cord, 58(1), 106–115. https://doi.org/10.1038/s41393-019-0345-6
37.
MinL.WangD.YouY.FuY.MaX. (2021). Effects of high-intensity interval training on sleep: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(20), Article 10973. https://doi.org/10.3390/ijerph182010973
38.
MuresanD.-A.PielmuşiM.-A.Perju-DumbravaL.FodorD. M. (2019). The effect of stretching exercises as part of the rehabilitation program for patients with spinal cord injury. Balneo Research Journal, 10(4), 462–465. https://doi.org/10.12680/balneo.2019.282
39.
MyersJ.KiratliB. J.JaramilloJ. (2012). The cardiometabolic benefits of routine physical activity in persons living with spinal cord injury. Current Cardiovascular Risk Reports, 6(4), 323–330. https://doi.org/10.1007/s12170-012-0238-0
40.
NamK. Y.KimH. J.KwonB. S.ParkJ. W.LeeH. J.YooA. (2017). Robot-assisted gait training (Lokomat) improves walking function and activity in people with spinal cord injury: A systematic review. Journal of NeuroEngineering and Rehabilitation, 14(1), Article 24. https://doi.org/10.1186/s12984-017-0232-3
41.
ParkJ. (2025). The effects of robot-assisted gait training using FES on lower limb strength and balance in stroke patients. Physical Therapy Rehabilitation Science, 14(1), 56–64. https://doi.org/10.14474/ptrs.2025.14.1.56
42.
ParkJ. M.KimY. W.LeeS. J.ShinJ. C. (2024). Robot-assisted gait training in individuals with spinal cord injury: A systematic review and meta-analysis of randomized controlled trials. Annals of Rehabilitation Medicine, 48(3), 171–191. https://doi.org/10.5535/arm.230039
RodriguezM. R.Fornieles GF. G.Rosety IR. I.Diaz AJD. A.Rosety MAR. M.Derbew MD. M.Ordonez FJO. F. (2013). Arm cranking exercise improves carbohydrate and lipid metabolic disorders in sedentary adults with chronic spinal cord injury. The Ethiopian Journal of Health Development, 27(3), 243–248. https://mail.ejhd.org/index.php/ejhd/article/view/164
45.
SatoT.KimuraR.KasukawaY.KudoD.HatakeyamaK.WatanabeM.TakahashiY.OkuraK.SudaT.MiyamotoD.IwamiT.MiyakoshiN. (2025). Effects of gait rehabilitation robot combined with electrical stimulation on spinal cord injury patients’ blood pressure. Sensors, 25(3), Article 984. https://doi.org/10.3390/s25030984
46.
SchicketmuellerA.RoseG.HofmannM. (2019). Feasibility of a sensor-based gait event detection algorithm for triggering functional electrical stimulation during robot-assisted gait training. Sensors, 19(21), Article 4804. https://doi.org/10.3390/s19214804
47.
ShackletonC. L. (2021). The effect of robotic walking and activity-based rehabilitation on functional capacity, secondary complications & psychological well-being in individuals with spinal cord injury (SCI)[Doctoral dissertation]. Faculty of Health Sciences, Department of Human Biology, University of Cape Town Repository. https://hdl.handle.net/11427/36118
48.
SilvaC. M. A. F. D.SáK. S. G. D.GorlaJ. I.FloresL. J. F.SilvaM. D. P. M. E.CoswigV. S.SilvaA. D. A. C. E. (2023). High-intensity interval training in people with spinal cord injury: A systematic review. Revista Brasileira de Medicina do Esporte, 30(9034), Article e2022_0193. https://doi.org/10.1590/1517-8692202430012022_0193i
49.
SmithR. C. (2021). Analytic autoethnography of familial and institutional social identity construction of My Dad with Alzheimer’s: In the emergency room with Erving Goffman and Oliver Sacks. Social Science & Medicine, 277(1), Article 113894. https://doi.org/10.1016/j.socscimed.2021.113894
50.
SparkesA. C.SmithB. (2005). When narratives matter: Men, sport, and spinal cord injury. Medical Humanities, 31(2), 81–88. https://doi.org/10.1136/jmh.2005.000203
51.
StorkM. J.BanfieldL. E.GibalaM. J.Martin GinisK. A. (2017). A scoping review of the psychological responses to interval exercise: Is interval exercise a viable alternative to traditional exercise?Health Psychology Review, 11(4), 324–344. https://doi.org/10.1080/17437199.2017.1326011
52.
van LangeveldS. A.PostM. W.van AsbeckF. W.ter HorstP.LeendersJ.PostmaK.RijkenH.LindemanE. (2011). Contents of physical therapy, occupational therapy, and sports therapy sessions for patients with a spinal cord injury in three Dutch rehabilitation centres. Disability and Rehabilitation, 33(5), 412–422. https://doi.org/10.3109/09638288.2010.498548
53.
WarburtonD.EngJ.KrassioukovA.SprouleS.the SCIRE Research Team. (2007). Cardiovascular health and exercise rehabilitation in spinal cord injury. Topics in Spinal Cord Injury Rehabilitation, 13(1), 98–122. https://doi.org/10.1310/sci1301-98
54.
WiestM. J.WestC.DitorD.FurlanJ. C.MiyataniM.FarahaniF.AlaviniaS. M.OhP. I.BayleyM. T.CravenB. C. (2019). Development of cardiometabolic health indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project. The Journal of Spinal Cord Medicine, 42(sup1), 166–175. https://doi.org/10.1080/10790268.2019.1613322
55.
WilliamsT. E.DeMarkL. A.OlarewajuT. A.HawkinsK. A.FoxE. J. (2024). Stretching after spinal cord injury: A call for evidence for this common clinical practice. Frontiers in Rehabilitation Sciences, 5, Article 1505439. https://doi.org/10.3389/fresc.2024.1505439
56.
YadavV.GeraC.YadavR. (2018). Evolution in hemiplegic management: A review. International Journal of Health Sciences & Research, 8(5), 360–369.
57.
ZbogarD.EngJ. J.NobleJ. W.MillerW. C.KrassioukovA. V.VerrierM. C. (2017). Cardiovascular stress during inpatient spinal cord injury rehabilitation. Archives of Physical Medicine and Rehabilitation, 98(12), 2449–2456. https://doi.org/10.1016/j.apmr.2017.05.009
