SCI Flashcards
Describe the focus of PT for an SIC that is level ASIA A
WONT: be able to strengthen or recover lost motor function
WILL: need to learn to compensate for loss of motor function (new way to do things)
List the factors that affect functional outcome (5)
- social hx
- family support
- work hx
- level of education
- home layout (important regardless of complete/incomplete SCI)
Describe the difference between short and long sitting for those with SCI
Short Sit: more difficult, can’t use HS
Long Sit: more stable; can use HS
Describe the best way to stretch HS in those with SCI
Supine over Long sitting
Long sit: with tight HS more likely to stretch the Lb than the HS; a tight back is important b/c it is better for transfers (butt won’t sag)
Describe tendodesis
Flexing of the fingers they are stretched across the wrist joint during wrist extension.
Can be used for functional grip in quads above C6
Describe the difference between tilt and recline
Tilt: hip angle doesn’t change, but chair moves back in space
Recline: hip angle increases
List the skin changes that occur in those with SCI (2)
- Thinning of epithelial layer
- Change in collagen and hyperhidrosis (T8 and above)
List the reasons that put those with SCI at high risk for pressure ulcers (4)
- impaired sensation
- physiologic changes
- inability to perform pressure relief
- Moisture control
List the rules of thumb for tetraplegia (2)
- Above C6 = power WC
- C7-T1 may be manual WC
List the rules of thumb for paraplegia (4)
- Typically manual WC
- Rigid frame (more energy efficient)
- Adjustable axel (for confidence in stability)
- Consider weight of WC components
List the pros and cons of a rigid back chair
Pro: better posture and shld positioning
Con: hassle in loading into the car
List cushions from least to most pressure relief
Foam > Gel > Air
List the factors that limit activity tolerance (4)
- upright tolerance
- respiratory status
- endurance
- pain
For upright tolerance list the
- Expected Outcomes
- Variance
- Difficulty maintaining BP, may benefit from abdominal binder or ace wrapping
- Dysreflexia
Condition: rise of SBP by 20 mmHg or greater in response to stimulus
(Autonomic) Dysreflexia
For respiratory function list the
- Expected Outcomes
- Variance
- C6/7 limited intercostal mm, difficulty handling secretions/coughing
- More difficulty weaning from vent, possible need for tracheostomy
For pain list the
- Expected Outcomes
- Variance
- Pain at injury site, NR pain
- Neurogenic pain below the level
For ROM list the
- Expected Outcomes
- Variance
- WFL, flaccid
- HO, contracture, spasticity, insufficient PROM
For Strength/Tone list the
- Expected Outcomes
- Variance
- Intact above, absent below, low tone initially, increased tone after spinal shock
- LE stronger than UE, unilateral difference, spasticity interfering w/function, proximal weakness
For sensation list the
- Expected Outcomes
- Variance
- absent below, intact above
- intact below, absent above, pain below
For bladder function list the
- Expected Outcomes
- Variance
- Neurogenic bladder (will not empty w/voluntary control)
- Frequent bladder distention can promote UTI
For bowel function list the
- Expected Outcomes
- Variance
- Neurogenic bowel (will not empty w/volitional control)
- obstruction, ileus
Term: absent or decreased bowel sounds and no stool or flatus passing
Ileus
Describe how a bowel obstruction in those with SCI may present
May present as diarrhea with loose stool passing around the obstruction
