Phases of Recovery

There are Five Phases of Recovery (as identified in the S.T.E.P. Method) that every client goes through after sustaining a spinal cord injury. The rate at which each client progresses is different and dependent on their body’s neurological response to our activity-based treatment and here at The Perfect Step we have clients in every phase of recovery. 


The goal of Phase I is to act as the client’s nervous system to stimulate responses. This is typically done through active assisted exercises or “Patterned Neural Activity Recruitment” (PNAR).

In Phase II we build on nervous pathways that are engaged during PNAR. We do this through the use of load bearing activities.

Reactivation or re-organization is the process of the nervous system bypassing the injury site and re-wiring itself to perform the job it was designed to do. These are the most difficult stages of the program and can be the longest in the road to recovery


The objective in Phase III is to initiate muscle contractions through positional movement or stimulation. This is where recovery really starts to move away from traditional occupational practices. Through this stimulation it is our belief that the nervous system is trying to connect the way it did before the spinal cord injury, but without the proper external stimulation to re-teach it, the result is spasm and tone.

During this recovery phase, clients will find themselves physically more tired than before. In this phase the client, with the help of the Paralysis Recovery Specialist, is responsible for doing the majority of the physical work without relying on the Specialists’ help. This emphasis on independent movement will cause their nervous system to recover slower than it did during Phases I and II. 


Known as the transition phase because the client has the ability to move and control their legs and arms, but do not have the strength or coordination to walk without aids; the goal of Phase IV is to improve coordinated movement through all planes of movement and motion. The evolution from Phase III to Phase IV can be long and arduous and quite frustrating, and even though not every person will make the transition, the positive support from their peers and specialist help make achieving this goal seem a little easier to attain.


The training program in Phase V is tailored to meet each client’s individual goals by providing advanced functional gait training for clients who are moving their legs or are able to walk with or without adaptive aids. At The Perfect Step, there are no guarantees, but we believe that the only time someone stops improving is when he/she is satisfied with their level of improvement. While one might be satisfied with just standing on their own, another may want to go beyond just standing and be able to walk on their own, surf or even snowboard.


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