Week 4.1 TI for Complete Paralysis

Question 1

what is the expected functional outcome for a C1-4 injury

Answer 1

total assist, maybe powered mobility, and may need a vent.

Question 2

expected function with C5

Answer 2

requires a great deal of assistance

Question 3

expected function from C6-8

Answer 3

more independent, may acquire some assistance.

Question 4

what is expected with T1-9

Answer 4

independent in all basic mobility, may need equipment. gait is variable

Question 5

what is the expected function from T10-L1

Answer 5

independent in all basic mobility, gait is likely, but still variable

Question 6

what is the expected function from L2-S5

Answer 6

independent in all, may need orthotics or AD

Question 7

with complete and seemingly permanent paralysis, what are the goals for interventions

Answer 7

compensation and substitution

Question 8

what are some pharmaceutical interventions for complete paralysis

Answer 8

corticosteroids to decrease inflammation and damage, DVT prevention, bowel and bladder medications and ED

Question 9

as a prep intervention, we can develop what type of movement strategies

Answer 9

compensatory

Question 10

what is muscle substitution

Answer 10

by synergists, gravity or tension of passive structures (like tenodysis grip), and the use of closed chain mechanisms (like propping not he UE with locked out elbows).

Question 11

what is a synergist muscle

Answer 11

a muscle that does the same function, but has a different innervation

Question 12

what are the 3 compensatory movement strategies for complete paralysis

Answer 12

muscle substitution,
momentum
head-hips relationships

Question 13

the head moves one way and the butt moves….

Answer 13

in the opposite direction.

Question 14

how should strengthening be used as a preparatory intervention

Answer 14

strengthen around the shoulders, and strength and endurance beyond 5/5. work on what is innervated

Question 15

how should we address ROM as a prep intervention

Answer 15

we should tighten what needs to be tightened, like posture muscles and tenodysis grip, and make sure we have the extra ROM where we need it

Question 16

is equipment important for function with complete paralysis

Answer 16

yes

Question 17

is strengthening for complete paralysis different from usual strengthening

Answer 17

not really, but need to work with less innervated things, and must protect the shoulder

Question 18

what is the challenge with ROM and stretching

Answer 18

challenging how to self-stretch. whether it is because of positioning or lack of tools

Question 19

what are some interventions applied to functional activities we can do

Answer 19

functional training, rolling, transition to sitting, long and short sitting, transfers, W/C skills, and advanced skills.

Question 20

what are some spine precautions

Answer 20

orthosis and restricted motions and there may be lifting restrictions

Question 21

what is a C-spine precaution

Answer 21

avoid strong contraction of the shoulder and avoid abduction or flexion over 90

Question 22

what is a L-spine precaution

Answer 22

avoid strong contraction of hip and avoid flexion over 90. also avoid SLR with vertebral movement

Question 23

with SCI, what do we want to prevent

Answer 23

fractures

Question 24

what are some other precautions when it comes to SCI and complete paralysis

Answer 24

skin protection, OH, AD

Question 25

what are some interventions beyond therapy

Answer 25

patient and caregiver information
patient needs to be able to tell us what they want
HEP to focus on flexibility, and strengthening,
Continue with functional practice
regular cardiovascular exercise
nutrition