expected outcomes - SCI Flashcards
what must be done when you think someone has a SCI
prompt diagnosis and severity assessment
when does recovery happen in those with incomplete injuries
1/2 -2/3 of motor recovery occurs in the first year
most of it occuring in the first 2 months after the injury
is recoverey fast in those with incomplete or complete injuries
incomplete
median for anti gravity strength complete
2 months
median for anti gravity strength incomplete
2 weeks
how many of those who are ASIA B will be ambulatory
50%
the prognosis depends on the type of sensory sparing
ASIA B and sacral pin sensation
those with sacral pin sensation have a similar prognosis as in those with incomplete motor injury
without sacral pin sensation amb rate vary from 10% - 30%
if you have motor incomplete injury are you expected to recover the ability to amb
majority of those with incomplete recovery amb functions
ASIA C amb
75% will be community amb
ASIA D amb
95% will be community amb
expected outcomes - C1-C4 bed mobility
total assist
expected outcome - C1 -C4 power wheel chair
indpendent using head, chin, mouth or breath control
expected outcome - C1 -C4 amb
no functional amb
expected outcome - C5 bed Mobilty
some assist with bed mobilty
expected outcome - C5 transfers
total assist with transfers
expected outcome - C5 power wheel chair
independent using hand controls
expected outcome - C5 manuel wheel chair
assist needed
expected outcome - C5 amb
no functional amb
expected outcome - C6 bed mobilty
some assist with bed mobilty
expected outcome - C6 transferes
some assist
or
indp
expected outcome - C6 power wheel chair
indp with power WC with hand controls
expected outcome - C6 manuel WC
possiblity of independence
expected outcome - C6 amb
no functional amb
expected outcome - C7-8 bed mobility
idep to some assist
expected outcome - C7-8 transfers
independent
expected outcome - C7-8 maneul wheel chair
independent
expected outcome - C7-8 amb
no functional amb
expected outcome - T1-9 bed mobility and transfers
indp
expected outcome - T1-9 manual WC
indep
expected outcome - T1-9 amb
functional amb is not typical
expected outcome - T10 -L1 BM and transfers
indep
expected outcome - T10 -L1 manual WC
indep
expected outcome - T10 -L1 amb
some assist to ind amb
typically using KAFO and lofstran crutches or walker
expected outcome - L2 -S5 BM and transfers
ind
expected outcome - L2 -S5 manual WC
ind
expected outcome - L2 -S5 amb
some assist to ind
using KAFO or AFO and lofstrands or a cane
at what injury level do we expect walking to be attainable
T10-L1
power WC ind
C4
transfer ind
C6
manual WC ind
C6
bed mobility
C5
what final segment is tenodesis needed till
C8
ROM and SCI
greater then normal ROM is needed at some joints and slight tightness is needed at other joints
in the absent of triceps what is needed for sitting
shoulder ext and ER
supination of the forearms
elbow ROM and SCI
full elbow ROM is needed for most functional activities especially for those who lack triceps
what is needed for a tenodesis grasp
full wrist ROM
mild finger tightness - want to avoid overstretching the longer finger flexors
low back and ROM needs
mild tightness is needed for transfers and mat table activties
the slump posture in sitting can overstretch the back
hip extension and amb
full hip extension is needed for amb
how many deg of a SLR is needed for dressing, unlevel transfers and STS with KAFO
11-120
how much DF is needed for amb
full DF ROM
in bed how often should you turn
every 2 hours
in the chair how often should you change positions
20-30 for 2 mins
what range can a tenodesis graps be used in
C6 through C7
at what level is wrist ext presserved
C6 and below
