SCI Intervention

Question 1

Intervention objectives should be designed around cooperative goals determined by

Answer 1

the client, the family, the occupational therapist, and other team members.

Question 2

What are the three phases of SCI rehab?

Answer 2

Acute recovery phase (AKA acute phase), acute rehab phase (AKA active phase of intervention), and transitional rehab phase

Question 3

The acute recovery phase, also called the acute phase, involves occupational therapy for short sessions limited to _____

Answer 3

15 minutes

Question 4

OT sessions in the acute recovery phase are often conducted in

Answer 4

The intensive care unit

Question 5

The focus of intervention in the acute recovery phase includes the following components:

i. Providing client and family support and education
ii. Allowing environmental control for the client, such as a nurse call button or bed controls
iii. Maintaining normal upper-extremity ROM, which can be done through ROM exercises and positioning, including splinting

Emphasis for ROM is movements involving scapular rotation, shoulder scaption, shoulder exter-
nal rotation, elbow extension, and forearm pronation

Answer 5

Client/family support and education
Allowing environmental controls for client such as call button and bed controls
Maintaining normal UE ROM via ROM exercises, positioning, and splinting.
Facilitating tenodesis grasp for clients with tetraplegia.
Ongoing evaluation of ability to sit upright and to begin training in ADLs
Possible evaluation of the client’s swallowing ability, depending on the level of injury

Question 6

Emphasis for ROM during the acute recovery phase for SCI is on

Answer 6

movements involving scapular rotation, shoulder scaption, shoulder external rotation, elbow extension, and forearm pronation

Question 7

Facilitating tenodesis grasp is important for clients with ___

Answer 7

tetraplegia

Question 8

Tenodesis splints should be positioned how?

Answer 8

dorsal and support the wrist in extension and thumb in opposition (preserving the web space), allowing the metacarpophalangeal and proximal interphalangeal joints to flex properly

Question 9

A total body positioning evaluation should include ___ needs

Answer 9

hand splinting needs.

Question 10

The acute rehabilitation phase, also referred to as the active phase of intervention includes (2 things)

.

Answer 10

providing education and support and helping the client

find meaningful activities that restore a sense of self-efficacy and self-esteem

Question 11

During the acute rehab phase, education occurs _____ throughout intervention sessions with the client

Answer 11

continuously

Question 12

Training in basic self-care allows for the opportunity to _____ For example,

Answer 12

reinforce management and monitoring of SCI impairments.

Question 13

For a client using a wheelchair and developing upright sitting tolerance, pressure ulcer awareness and reduction should begin during the acute rehab phase, and the client should be trained to shift weight every __ to __ min

Answer 13

30–60 minutes

Question 14

During the acute rehab phase, caregiver training should be provided in the areas of (6 things)

Answer 14

ROM, positioning, pressure relief, ADL assistance,equipment use, and areas of SCI impairment

Question 15

Clients with C5 tetraplegia may benefit from _____ to assist in performing functional activities.

Answer 15

mobile arm support

Question 16

Clients with C5 tetraplegia could benefit from using ___ or ___ in order to grasp and hold objects requiring wrist stabilization.

Answer 16

Universal cuff or C clamp

Question 17

C8 tetraplegia interventions should focus on grasping objects with (2 movements at specific joints)

Answer 17

metacarpophalangeal joint extension and proximal and distal interphalangeal joint flexion.

Question 18

Clients with C6 and C7 tetraplegia have more fully innervated shoulder girdles, allowing greater force for (2 things)

Answer 18

rolling in bed and crossing the midline with the arms.

Question 19

For clients with C6 and C7 tetraplegia, Grasping of objects is facilitated by innervation of the _____ which allows for tenodesis.

Answer 19

radial wrist extensors,

Question 20

For clients with C6 and C7 tetraplegia, innervation of the radial wrist extensors allows for ____

Answer 20

tenodesis

Question 21

For clients with C6 and C7 tetraplegia,____ (or ____) is useful in maximizing pinch strength

Answer 21

wrist-drive wrist–hand orthosis (or tenodesis

splint)

Question 22

____ begins immediately and is most prominent during the acute rehabilitation phase

Answer 22

Psychosocial adaptation

Question 23

Psychosocial adaptation is most prominent during which phase?

Answer 23

Acute rehab phase

Question 24

The transition rehabilitation phase may involve outpatient occupational therapy services if the client

Answer 24

has been unable to achieve optimal outcomes in the acute rehabilitation phase

Question 25

The focus of interventions in the transitional rehab phase is to

Answer 25

Maximize strength gains in the first year postinjury.

Continued training in the use of adaptive devices and consideration of the use of other equipment

Facilitating access to support groups and interventions that enhance community integration should be a focus.