What to expect

You send the ASIA classification, imaging, the operation note if there was surgery, and a description of current function. A rehabilitation physician reads them and writes back within 48 hours with what is realistic, which programme, how long, and which centre. If we do not think the travel is justified, the reply says that.

Practical arrangements — visa letter, airport transfer, wheelchair assistance on the flight, a bed for the companion — are handled by the international office before departure, not on arrival.

The first days are measurement rather than treatment: ASIA classification repeated by our own physician, sitting tolerance, blood pressure response to being upright, skin condition, current bladder and bowel routine, and hand function if the injury is cervical.

Therapy starts at a lower intensity and builds. This is the week families find slowest and it is the week that prevents the setbacks.

Full intensity. Transfers, strength, balance, wheelchair skills, and robotic or hydrotherapy sessions where they are in the plan. Bladder and bowel training runs in parallel from the start rather than being added at the end.

The plan is reviewed weekly against the goals set in week one. Goals that turn out to be wrong get changed — that is what the review is for.

The focus shifts from what happens in the therapy room to what happens at home. Companion training moves from observation to doing it unsupervised. Equipment is specified — cushion, chair, transfer board — and where possible sourced before discharge rather than after.

You leave with a written home programme and a discharge document intended for a clinician in your own country, in a language they can read.