SCI Transfers & Bed mobility Flashcards
What are the transfer options for complete vs incomplete injury?
Complete: scoot pivot
Incomplete: scoot and stand pivot (must consider strength, spasticity, ASIA level)
Should we ever let go of a HALO patient?
NO at high risk for injury if fall
What are patients with stabilizations at higher risk?
a stabilization causes higher segments to be more mobile making them more susceptible to injury
What effects does the tension in passive structures have on stability?
it increases it
What are the 3 key strategies for a SCI transfer?
muscle substitution, momentum, head hips relationship
When should we aim for compensation vs remediation
compensation when there is a complete injury
remediation when there is an incomplete injury
What are the 2 primary forms of neural recovery?
spontaneous and neural plasticity
What is neural plasticity? where? good?
a form of neural recovery that can happen at both the cortical and spinal cord level.
is not always good as it could potentially lead to a dysreflexia
What occurs with neural plasticity?
synaptic & neurotransmitter changes
axonal sprouting
changes to intracellular properties
What are the pre-requisites to motor function?
strength; ROM; balance; endurance; psychosocial chars. (mood, motivation, personality)
What are the most common clinical approaches to restoring motor function post SCI
Therapeutic exs; FES; Task specific functional training; robotics; body weight support treadmill training
When teaching a patient with a SCI what form of practice should be utilized early on?
part practice
What are the various methods of muscle substitution?
substitution with gravity; substitution with tension in passive structures; fixation of distal extremity
What is the head hips relationship?
head and hip move in opposite directions; can help to unload when trying to move….moving head toward knees unweights the hips (not end all be all)
What is the major key to using a momentum strategy?
using as many joints as possible in order to increase/maximize force
Supine to sidelying C1-4
dependent
Supine to sidelying C5
hook technique
Supine to sidelying C6-8 options?
hook technique; momentum
Can a C1-4 move prone to supine?
no
Method of C5-6 moving prone to supine?
push using rhomoids, delts, middle trip; will need help with lower trunk
Method of C7-8 moving prone to supine?
push with arms and turn head in desired direction until roll; then reposition legs
Supine on elbows is achieved how for C5 and C6?
C5: needs assistance
C6: wedge, muscle up
