spinal cord injury Flashcards
SCI can be what type of two others injuries
quadriplegia and paraplegia
SCI are acquired by what
trauma
what are the causes of SCI and what pourcentages are each of those causes
48% motor vehicles
21% falls ( increase in construction workers and seniors)
14% violence (gunshot)
14% sport injuries (recreational & competitive sports)
3% others
what is the number 1 sport to cause sci
diving (pool, lake)
in canada how many new cases of sci per year and how many canadians live with sci
1100 new cases per year and 44 000 canadians live with it
how much does lifetime health care cost per person w sci
1.6 to 3 million
why is there such a wide range of costs with sci
bc of severity (quadraplegia is more $$ than paraplegia) and age (services for longer)
about __ % are males and range in age btw __ and __
80%, btw 16 and 30 yo
why are males more prone to this at younger ages
bc males drive cars faster and are more reckless
Lesions can either be complete or incomplete with what ratio
50%-50% complete-incomplete
in the past were there more complete or incomplete lesions
complete
the decrease in % of complete lesion is due to … (3)
meds
car safety belt + airbags
paramedics (spinal immobilization)
sensory info
ascending pathways (dorsal tracts)
cutaneous info+ proprioception = ___
somatosensory system
are sensations intact above the lesion
yes
motor commands
descending pathways (ventral tracts)
can an individual with a spinal cord lesion at the lumbar level contract his arm muscles
yes to move arm m. you need cervical to move legs (no work), won’t reach level needed
severity of condition depends on
level of lesion
whether its complete or incomplete (injury can affect more than one vertebra)
quadriplegia characteristics (4)
involvement:
cause:
most common damage sites
involvement of all 4 limbs and trunk
cause: damage to cervical segments
C5-C6 most common bc of car accidents
C7: elbow extension, important for wc users bc of tricep innervation (propelling motion of the wc)
paraplegia characteristics (2)
involvement of lower limbs and/or trunk (trunk isnt always involved bc T1 to L5)
cause: damage to the thoracic or lumbar spine
paraplegia complete lesions by sections
T1 to T6 = no sitting balance
T7 to L1 = some useful sitting
L2 to lower = normal trunk control
why is lesions classification important for WC sports
for classification in those sports (better athlete if better trunk control)
Health concerns in sci
sensation lost
complete lesion = total loss (below lesion)
incomplete lesion = partial loss (below lesion)
- lose some sensations but not others (hot vs cold… type of fibers)
- vulnerable to injury (visual inspection after playing sports)
Health concerns in sci
contractures and injury prevention (spasticity)
shortening and tightening of muscles
- flexors in upper limbs
- extensors in lower limbs
stretching 2x /day (full ROM)
what can a dorsal hand splint treat
spasticity and contracture
what are the two types of spasticity
triple flexion and PF+ankle inv
Health concerns in sci (6)
sensation loss
contractures and injury prevention (spasticity)
lower limb atrophy
osteoporosis
weight management (more prone to hypokinetic disease)
ANS dysfunction during exercise
lower limb atrophy, osteoporosis and weight management are very common in wc users bc of a decrease in …
m. contraction (paralysis) mechanical loading on bones energy expenditure (what you eat vs what you burn during the day)
ANS dysfunction during exercise will cause what
decrease heart beat, BP
sweat impairment
impairment of vasoconstrictor function=reduced blood to heart=reduced O2 to m. = early fatigue (narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels)
ANS is part of the ns that regulates ___
involuntary function
sympathetic system during exercise
increase HR, constricts blood vessels and increase in BP
cardiac sympathetic fibers originate from …
T1 to T5
any injuries from C1 to T5 is a dysfunction to what sys
ANS
ANS dysfunction can be present in __ and ___
quadriplegics and high paraplegics (lesions at T5 and above)
where does the ANS signal originate from
brain stem
high intensity exercises (may or may not) be tolerated in persons with quad and high para because of ____
hypotension (impaired blood distribution)
high intensity exercises may not be tolerated in persons w quad or high para: cause and symptoms
cause: sympathetic ns (ANS dysfunction)
symptoms: dizziness or nausea (feeling faint)
special recommendations for exercise programming (SCI), percentage in each disease
decrease in cardiovascular capacity and endurance after SCI; decrease 50% in para and 75% in quad
what happens to SCI people’s active m mass during exercise
decrease bc lower limb m.: 2/3 of our m. mass
quad: greater loss than para = greater loss of cardiovascular capacity
what happens to ANS when dysfunction is present
decrease in drive from symp ns (HR cannot be raised over 110-120 bpm)
cardiovascular training may include arm ergometer
arm ergometer:
- suitable for use in home or in center
- workload can be adjusted (like leg ergometer)
- grip cuffs used for quadra
cardiovascular training may include locomotor training
locomotor training with crutches or body weight support (overhead harness)
- can increase m strength and bone mineral density
- can prevent pressure sores ( by increase in blood circulation)
cardiovascular training may include wc propulsion using rollers
rollers are to wc users what treadmills are to ambulatory runners
to prevent upper extremity overuse syndromes in wc users (3)
vary exercises from week to week
strengthen m. of upper back and post shoulder (ext sh rotators)
stretch m of ant sh and chest
to prevent contractures and injuries
stretching exercises for lower and upper extremities
chest stretch (hand clasped behind back)
clasp hands behind your back
take a deep breath in
exhale and roll your sh back as you stick out your chest and hold (20-30s)
unclasp hands and relax
shoulder retraction
take breath in
exhale and bring shoulders back as far as you can
squeezing sh blades inward
triceps stretch
take deep breath in extend both arms above head reach down center of back with one arm exhale while pressing down slightly with opposite hand on elbow repeat on opposite side
seated chest stretch in door way
place arm bent at 90° in doorway
take deep breath in
exhale while turning head to opposite side looking over that sh
repeat w other arm looking over opposite sh
what are some sport that have specific wc
tennis, basketball, rugby, racing and more
common characteristics among sports chairs
no push handles
dont fold
wheel camber
anti-tipping support (all but racing chair)
basketball wc & rugby wc
fixed camber bars rollerblade casters anti-tipping support spoked wheels + quick release adjustable back and footplate height
unique to rugby wc
front bumper and wings
racing wc
2000 to 5000
camber of 11-15° (higher range is more stable)
tubular tires; integral tube and tire combined
hand ring mounted onto the rear wheel for propulsion
fenders provide protection for torso and arms from road debris and the rear wheel
steering; allows the athlete to maneuver the front wheel during sharp turns
frame: base of chair, usually made of aluminium
cage: seating area built according to body dimensions
short propulsion thrusts in what activities
ADL, basketball, tennis, most sports except for racing
short propulsion steps
- athlete pushes forward and downwards while moving trunk forward
- handrims are released and trunk returns to its upright position
long duration circular propulsion thrust in what sports
track and marathon racing
long duration circular propulsion thrust steps
- athlete maintains hands in contact with the handrims through 3/4 of a circle applying force the entire time; grip on handrims is never released
- flexed position at the trunk
- sh extension provides the final propulsive thrust
wc basketball rules
5 players/team net 10 feet 3 sec in key dribble, shoot or pass after 2 pushes no double dribble rule raise butt off chair = technical foul open to able-bodied (no major competitions)
what is harder in wc basket vs normal
dribbling, throwing
to be elligible to play wc basket an athlete must have …
a permanent physical disability in the lower limbs that prevents him or her from running, jumping and pivoting as an able-bodied player
player classification is …
not based on medical diagnosis but on observed trunk mvt and stability during actual basketball competition
players are assigned on a point value from…
1.5 thru 4.5 according to their level of physical function. these points are then added together with a team not permitted to exceed 14 pts for the five players on court at any given time. this ensures that any player, regardless of degree of disability, has an integral role to play within the team structure.
wc basket is mainly played by players w ___. which condition comes second?
SCI
amputation
adapted tennis rules
individuals or pairs ball may bounce once or twice, with the first bounce in the opponents court scoring is the same played by people with para and quadra created in 1976 in usa more than 6000 players worldwide
adapted rugby
objective: score pts by carrying the ball to the opponent’s goal line (in wc)
very fast, contact team sport
played with volleyball
played with hands or forearms
must dribble or pass at least once every 10 s
goal scored when player touches the goal line w 2 wheels
there are a number or violations: charging, interference, etc.
