Spinal Cord Injury (SCI)

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Questions and Answers

What is the primary role of the spinal cord?

  • To facilitate communication between the brain and body (correct)
  • To filter toxins from the blood
  • To regulate body temperature
  • To control the digestive system

Which level of spinal cord injury typically affects the muscles needed for breathing, potentially requiring ventilator support?

  • Cervical (correct)
  • Lumbar
  • Thoracic
  • Sacral

What is the most frequent cause of traumatic spinal cord injuries?

  • Falls
  • Acts of violence
  • Sports-related accidents
  • Motor vehicle accidents (correct)

Which of the following is a non-traumatic cause of spinal cord injury?

<p>Infection (D)</p> Signup and view all the answers

Approximately what percentage of people with spinal cord injuries are men?

<p>78% (C)</p> Signup and view all the answers

Pneumonia is the leading cause of death for individuals with spinal cord injuries. What condition is the second leading cause?

<p>Ischemic heart disease (D)</p> Signup and view all the answers

Which of the following is a primary effect of spinal cord injury?

<p>Loss of motor control (B)</p> Signup and view all the answers

A patient with a spinal cord injury is experiencing a sudden onset of hypertension, bradycardia, and a severe headache. What condition is likely occurring?

<p>Autonomic dysreflexia (B)</p> Signup and view all the answers

What is the immediate treatment for autonomic dysreflexia?

<p>Sit the patient up and identify/remove the cause of the noxious stimuli (A)</p> Signup and view all the answers

Which of the following exercise goals is most important for individuals with spinal cord injury?

<p>Maintain and improve range of motion and strength (D)</p> Signup and view all the answers

Before prescribing an exercise program for an individual with a spinal cord injury, what is the most important first step?

<p>Consult with a physician to ensure medical clearance (B)</p> Signup and view all the answers

For individuals with lower extremity paralysis, strength training is crucial. Why?

<p>To rely on their arms for mobility (D)</p> Signup and view all the answers

Which of the following exercise types is BEST for improving heart health and endurance in individuals with spinal cord injuries?

<p>Cardiovascular training (C)</p> Signup and view all the answers

What is the primary benefit of regular stretching and range of motion exercises for individuals with spinal cord injuries?

<p>Preventing stiffness and joint contractures (A)</p> Signup and view all the answers

Which of the following pieces of equipment is specifically designed to provide body weight support during exercise, helping individuals with SCI to practice walking or other weight-bearing activities?

<p>Zero G Body weight support system (D)</p> Signup and view all the answers

Which of the following refers to exercise equipment that uses electrical stimulation to activate paralyzed muscles during activity?

<p>FES cycle ergometry (B)</p> Signup and view all the answers

Which of the following is a key consideration when designing a cardiovascular training program for a patient with a spinal cord injury?

<p>Monitoring the rate of perceived exertion (A)</p> Signup and view all the answers

What is the main purpose of adapted exercise equipment for individuals with spinal cord injuries?

<p>To allow them to perform exercises independently and safely (D)</p> Signup and view all the answers

Which of the following is an example of an adapted exercise equipment?

<p>Arm cycle ergometry (D)</p> Signup and view all the answers

If a patient with a spinal cord injury needs to improve their ability to perform daily tasks that involve reaching and pulling, which type of adapted equipment would be MOST beneficial?

<p>Cable column with adapted gloves (A)</p> Signup and view all the answers

Which of the following is a potential benefit of using an exoskeleton for exercise in individuals with spinal cord injuries?

<p>Improved bone density (B)</p> Signup and view all the answers

Why is strength training important for patients with spinal cord injuries?

<p>It builds strength, especially in the upper body, which is crucial for daily living. (A)</p> Signup and view all the answers

What does cardiovascular training do for patients with spinal cord injuries?

<p>It helps improve heart health and endurance. (C)</p> Signup and view all the answers

What do regular stretching and range of motion exercises do for patients with spinal cord injuries?

<p>It helps prevent stiffness and joint contractures. (C)</p> Signup and view all the answers

Which of the following best describes the mechanism by which the Alter G anti-gravity treadmill assists with rehabilitation?

<p>It reduces body weight to decrease impact during exercise. (A)</p> Signup and view all the answers

Following a spinal cord injury, what is the MOST likely reason for a patient to use a standing frame?

<p>To prevent joint contractures and improve bone density (C)</p> Signup and view all the answers

A physical therapist is working with a patient who has a spinal cord injury and limited hand function. To facilitate exercises targeting specific muscle groups, which type of adaptive equipment would be MOST useful?

<p>Cable column with adapted exercise gloves (A)</p> Signup and view all the answers

Which of the following would be a key focus when incorporating flexibility and range of motion exercises into a rehabilitation program for a patient with spinal cord injury?

<p>Focusing on major joints such as shoulders, hips, and ankles (D)</p> Signup and view all the answers

For an individual with a spinal cord injury at the T6 level, which of the following would be the MOST appropriate initial cardiovascular exercise prescription?

<p>Arm ergometry at a moderate intensity (D)</p> Signup and view all the answers

Compared to individuals without spinal cord injuries, what modification may be necessary when prescribing strength training exercises?

<p>Using lighter weights and higher repetitions (C)</p> Signup and view all the answers

Which of the following is a crucial consideration when monitoring an individual with a spinal cord injury during exercise?

<p>Observing for signs of autonomic dysreflexia (B)</p> Signup and view all the answers

How might an exercise program assist in preventing a common secondary complication?

<p>Reduced incidence of osteoporosis (D)</p> Signup and view all the answers

A physical therapist is designing an exercise program for a client with a spinal cord injury. Which of the following is the MOST appropriate way to engage the client in goal setting?

<p>Collaboratively setting goals based on the individual's needs and preferences. (C)</p> Signup and view all the answers

A client post spinal cord injury expresses concerns about participating in exercise due to fear of falling. Which of the following would be MOST appropriate intervention.

<p>Providing education and modifying exercises to minimize fall risk. (D)</p> Signup and view all the answers

Flashcards

Spinal Cord Injury

Damage to the spinal cord resulting in loss of function below the injury level.

Function of Spinal Cord

The spinal cord acts as the communication mean between the brain and body, sending motor commands and sensory information.

SCI Impairment

Loss of function depends on the level of spinal cord injury: cervical, thoracic, lumbar, or sacral.

Traumatic SCI Causes

Traumatic causes like motor vehicle accidents, violence, falls, and sports can result in spinal cord injury.

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Non-Traumatic SCI Causes

Infections, tumors, vascular malfunctions, multiple sclerosis, ALS and Guillain-Barre can cause cause spinal cord injury.

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Primary SCI effects

Loss of motor control, spasms, sensory loss, respiratory issues, incontinence, sexual dysfunction, cardiovascular problems, impaired temperature regulation are primary effects.

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Secondary SCI complications

Skin breakdown, respiratory complications, osteoporosis, DVTs, GI issues, pain, UTIs, orthostatic hypotension, and autonomic dysreflexia are secondary complications.

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Autonomic Dysreflexia

Pathologic auto immune reflex from noxious stimuli below injury (above T6) causing hypertension, bradycardia, headache and profuse sweating.

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SCI Exercise Goals

Maintain/improve ROM, strength, endurance, prevent medical complications, improve self-confidence, body image, and well-being.

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Exercise Program

Consult physician and tailor exercise program to meet individual goals.

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Exercise Types for SCI

Strength, cardiovascular, flexibility, ROM training, and adapted equipment.

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Strength Training (SCI)

Resistance training builds upper body strength for daily activities; crucial for individuals with lower extremity paralysis.

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Cardiovascular Training (SCI)

Exercises like arm cycling, wheelchair ergometry, swimming improve heart health/endurance; monitor exertion.

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Flexibility and ROM (SCI)

Regular stretching and ROM exercises help prevent stiffness and joint contractures; focus on shoulders, hamstrings, hip flexors, and ankles.

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Arm Cycle Ergometry

Arm cycle ergometry uses arms to simulate cycling exercise effectively for cardiovascular fitness.

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FES Cycle Ergometry

FES cycle ergometry uses electrical stimulation to activate muscles during cycling, helping paralyzed limbs move in a coordinated pattern.

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FES Elliptical

The FES elliptical is electrical stimulation helps muscles move.

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Zero G Body Weight

The zero G body weight support system is harness that suspends patients.

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Anti-Gravity treadmill

The alter G anti-gravity treadmill is a device that uses air pressure to prevent patients from falling.

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Exoskeleton

An exoskeleton is a device that is work over the legs to improve mobility.

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Standing Frame

A standing frame is a frame that supports a patient to stand up.

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Study Notes

Spinal Cord Injury (SCI)

  • SCI happens when the spinal cord, which communicates between the brain and body, is damaged.
  • Motor commands travel from the motor cortex to muscles, while sensory information goes from afferent fibers to the sensory cortex via the spinal cord.
  • Damage to the spinal cord results in loss of function below the injury level.
  • Impairment from SCI depends on where the injury occurred.
  • Injury can occur at the Cervical (neck) level.
  • Injury can occur at the Thoracic (trunk) level.
  • Injury can occur at the Lumbar (lower back) level.
  • Injury can occur at the Sacral level.

Causes of SCI

  • Traumatic SCI is most frequently caused by motor vehicle accidents which account for 36%.
  • Violence accounts for 29% of traumatic SCI.
  • Falls account for 22% of traumatic SCI.
  • Sports account for 8% of traumatic SCI.
  • Non-traumatic SCI can be caused by infection or tumor.
  • Vascular malfunction is a cause of non-traumatic SCI.
  • Non-traumatic SCI can be caused by multiple sclerosis, ALS, or Guillain Barre.

Patient Characteristics and Incidence Data

  • 78% of SCI patients are men.
  • Approximately 10,000 people survive SCI each year.
  • The average age of a SCI patient is 43 years old.
  • The total SCI population in the US ranges from 250,000–400,000 people.
  • Approximately 17,000 new spinal cord injuries occur each year.
  • The leading cause of death for SCI patients is pneumonia; ischemic heart disease is the second leading cause.

Primary Effects of SCI

  • There is loss of motor control and spasms occur in muscles.
  • Sensory loss occurs.
  • Respiratory function is impaired.
  • Bowel and bladder incontinence occurs.
  • Sexual dysfunction occurs.
  • Cardiovascular function is impaired.
  • The ability to regulate temperature is impaired.

Secondary Complications of SCI

  • Skin breakdown and respiratory complications can occur.
  • Osteoporosis and DVTs (deep vein thrombosis) can occur.
  • GI complications and pain can occur.
  • Urinary tract infections, Orthostatic hypotension and autonomic dysreflexia can occur.

Autonomic Dysreflexia

  • Autonomic dysreflexia is a pathologic autoimmune reflex in people with spinal cord injuries above T6.
  • It involves an acute onset of autoimmune activity from noxious stimuli below the injury level.
  • Symptoms of Autonomic Dysreflexia: hypertension, bradycardia, headache, profuse sweating, restlessness, spasms, congestion, goosebumps.
  • Autonomic Dysreflexia is a life-threatening event.
  • Treatment for Autonomic Dysreflexia: Sit the patient up, identify the cause, and remove the noxious stimuli.

Exercise Goals for Post Spinal Cord Injury

  • Maintain and improve range of motion and strength.
  • Maintain and improve endurance/cardiovascular system.
  • Prevent medical complications.
  • Improve self-confidence, body image, and well-being.
  • Consult a physician to ensure medical clearance for the exercise program.
  • Discuss individual goals and tailor the program to meet them.

Exercise Types

  • Strength training
  • Cardiovascular training
  • Flexibility and range of motion
  • Adapted exercise equipment.

Strength Training

  • Resistance training helps maintain and build strength, crucial for upper body activities of daily living.
  • Individuals with lower extremity paralysis need to rely on their arms for mobility, including transfers and wheelchair locomotion.

Cardiovascular Training

  • Activities like arm cycling, wheelchair ergometry, swimming, and arm-powered cycling can improve heart health and endurance.
  • It is important to monitor and use rate of perceived exertion scale.

Flexibility and range of motion.

  • Regular stretching and range of motion exercises can prevent stiffness and joint contractures.
  • Important areas to focus on include: shoulders, hamstrings, hip flexors and ankles

Adapted Exercise Equipment

  • Arm cycle ergometry
  • FES cycle ergometry or FES elliptical
  • Zero G Body weight support system
  • Alter G anti gravity treadmill
  • Exoskeleton
  • Standing frame
  • Cable column with adapted exercise gloves
  • Upper tone, Vita Glide and Rickshaw

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