SCI Transfers & Bed mobility

Question 1

What are the transfer options for complete vs incomplete injury?

Answer 1

Complete: scoot pivot
Incomplete: scoot and stand pivot (must consider strength, spasticity, ASIA level)

Question 2

Should we ever let go of a HALO patient?

Answer 2

NO at high risk for injury if fall

Question 3

What are patients with stabilizations at higher risk?

Answer 3

a stabilization causes higher segments to be more mobile making them more susceptible to injury

Question 4

What effects does the tension in passive structures have on stability?

Answer 4

it increases it

Question 5

What are the 3 key strategies for a SCI transfer?

Answer 5

muscle substitution, momentum, head hips relationship

Question 6

When should we aim for compensation vs remediation

Answer 6

compensation when there is a complete injury

remediation when there is an incomplete injury

Question 7

What are the 2 primary forms of neural recovery?

Answer 7

spontaneous and neural plasticity

Question 8

What is neural plasticity? where? good?

Answer 8

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

Question 9

What occurs with neural plasticity?

Answer 9

synaptic & neurotransmitter changes
axonal sprouting
changes to intracellular properties

Question 10

What are the pre-requisites to motor function?

Answer 10

strength; ROM; balance; endurance; psychosocial chars. (mood, motivation, personality)

Question 11

What are the most common clinical approaches to restoring motor function post SCI

Answer 11

Therapeutic exs; FES; Task specific functional training; robotics; body weight support treadmill training

Question 12

When teaching a patient with a SCI what form of practice should be utilized early on?

Answer 12

part practice

Question 13

What are the various methods of muscle substitution?

Answer 13

substitution with gravity; substitution with tension in passive structures; fixation of distal extremity

Question 14

What is the head hips relationship?

Answer 14

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)

Question 15

What is the major key to using a momentum strategy?

Answer 15

using as many joints as possible in order to increase/maximize force

Question 16

Supine to sidelying C1-4

Answer 16

dependent

Question 17

Supine to sidelying C5

Answer 17

hook technique

Question 18

Supine to sidelying C6-8 options?

Answer 18

hook technique; momentum

Question 19

Can a C1-4 move prone to supine?

Answer 19

no

Question 20

Method of C5-6 moving prone to supine?

Answer 20

push using rhomoids, delts, middle trip; will need help with lower trunk

Question 21

Method of C7-8 moving prone to supine?

Answer 21

push with arms and turn head in desired direction until roll; then reposition legs

Question 22

Supine on elbows is achieved how for C5 and C6?

Answer 22

C5: needs assistance
C6: wedge, muscle up