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Neuro Eval II > Prognosis > Flashcards

Prognosis Flashcards

1
Q

Things to consider for motor incomplete SCI

A
  • more variable, restoration
    Consider:
     Degree of motor return below level of injury
     Insurance coverage
     Access to ongoing PT/rehab
     Housing options & accessibility
     Body habitus
     Age
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2
Q

Things to consider for motor complete SCI

A
  • more predictable, compensation
     Body habitus
     Age
     Flexibility
     Adaptive equipment (AE)/Durable Medical Equipment (DME)
     Insurance coverage
     Housing options & accessibility
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3
Q

C1-C3 Motor Complete Expected Functional Outcomes

A
  • Dependent (TotalA) mobility & self care
  • Possibly independent with PWC
  • Ventilator/phrenic nerve stimulator
  • Directs care
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4
Q

C4 Motor Complete SCI Expected Functional Outcomes

A
  • Dependent (TotalA) mobility & self care
  • Assistance for ADLs w/ use of mobile arm support & other AE
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5
Q

C5 Motor Complete SCI Expected Functional Outcomes

A
  • Mobile arm support for UE ADLs
  • Min-modA LE dressing
  • Min-modA rolling
  • Dependent (TotalA) transfers
  • Independent PWC mobility in community
  • Manual cough assist
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6
Q

C6 Motor Complete SCI Expected Functional Outcomes

A
  • Independent slideboard transfers (possible)
  • Independent rolling
  • Independent unsupported sitting
  • ModI w/ AE for self care * Dress with some assistance for efficiency
  • MWC independence possible (likely household) w/ adapted rims
  • Independent manual cough
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7
Q

C7 Motor Complete SCI Expected Functional Outcomes

A
  • Independent seated self care (likely with AE)
  • Independent transfers w/o slideboard including floor & unlevel
  • Independent stowing MWC into car
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8
Q

C8 Motor Complete SCI Expected Functional Outcomes

A
  • Independent transfers including floor & unlevel
  • Independent toilet/tub transfers (possibly need grab bars)
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9
Q

T1-T5 Motor Complete SCI Expected Functional Outcomes

A
  • Curb negotiation with wheelies
  • WC sports participation * Independent car transfers
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10
Q

T6-T8 Motor Complete SCI Expected Functional Outcomes

A
  • Supervision with walker & KAFOs at home
  • MWC for community mobility
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11
Q

T9-T12 Motor Complete SCI Expected Functional Outcomes

A
  • Independent floor & tub transfers
  • Independent household ambulation w/ KAFOs
  • MWC for community mobility
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12
Q

T12-L3 Motor Complete SCI Expected Functional Outcomes

A
  • Independent gait w/ forearm crutches & KAFOs
  • May be community ambulator or use MWC for energy conservation
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13
Q

L4-L5 Motor Complete SCI Expected Functional Outcomes

A
  • Likely community ambulators w/ bracing (AFOs) and possibly assistive devices
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14
Q

What is the gait training approach for incomplete injuries?

A

Restorative

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15
Q

Prognosis for recovery of gait

A

AIS A: poor
AIS B: 33%, variable, more likely with PP preservation
AIS C: 75%
AIS D: 100%

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16
Q

What is the gait training approach for complete injuries?

A

Complete

17
Q

Positive Prognostic Indicators:

A
  • Age <65
  • Lower extremity motor function (any) –> L3 and S1 key myotomes
  • Pinprick sensation sparing –> L3 & S1 key dermatomes
  • AIS C or D classification
18
Q

What is the Clinical Prediction Rule for Locomotor Recovery Post SCI

A
  • AIS Testing administered within 15 days and 1 year post-injury independent walking (SCIM) used as primary outcome
    1. Lower extremity motor scores for quads and PFs
    2. Sensory scoring (light touch) for L3 and S1 dermatomes
    3. Age (> or <65)
19
Q

What can dictate the type of gait interventions in your POC?

A

Spinal Cord Level of injury
regardless of severity

20
Q

Injury above L1

A

= upper motor neuron (UMN) injury → follows
recovery pattern for CNS damage – similar to CVA or TBI
 Experience-dependent principles of neuroplasticity
 PT should include task-specific, repetitive, high intensity stepping training

21
Q

Injury below L1

A

= lower motor neuron (LMN) injury → follows
recovery pattern for PNS damage
 Time for regrowth of peripheral nerves approx. 1-2 mm/day
 PT should accommodate for deficits to maximize functional
independence – bracing, etc (KAFOs)

22
Q

What is restoration gait training

A

application of experience-dependent principles of neuroplasticity
- focus on neurologic recovery of walking function
- Implementation: using various modalities, CPG to improve locomotor function following chronic stroke/incomplete SCI and brain injury

23
Q

Manual Wheelchair - Rigid

A
  • For full time independent MWC users
  • Usually lower-level complete injuries
  • can be challenging to get into car bc it doesnt fold
24
Q

Manual Wheelchair - Folding manual

A

 For part-time independent MWC users (some level of ambulation)
 For MWC users who may require assistance

Neuro Eval II (16 decks)

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