Spinal Cord Disabilities

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chapter 16

• Spinal Cord Disabilities

Luke E. Kelly
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Spinal Cord Disabilities

• Common spinal cord injuries
• Traumatic injuries quadriplegia and paraplegia
• Spina bifida
• Polio
• Spinal column deviations
• Scoliosis
• Kyphosis and lordosis
• Spondylolysis and spondylolisthesis

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Classification and Function

• Classification systems
• Medical
• Sport
• Relevant factors
• Respiration
• Shoulder, arm, hand control and sensation
• Trunk stability
• Hip, knee, ankle control and sensation
• Bowel and bladder control
• Quadriplegia and paraplegia

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Handling Potential Spine Injuries

• Treat all possible injuries as serious.
• Immobilize neck.
• Restore breathing and circulation.
• Summon medical help.
• Keep victim warm.

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Treatment Phases

• Hospitalizationacute medical treatment
• Rehabilitation
• adjustment to injury
• basic living skills
• Return to home or schooltransition back to a
  normal routine

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Secondary Issues

• Psychological acceptance
• Health conditions
• decubitus ulcers
• bruising
• urinary tract infections
• spasticity
• contractures
• obesity

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Spina Bifida

• Spina bifida classifications
• occulta
• meningocele
• myelomeningocele
• Hydrocephalusshunts
• Chiari II malformation
• Tethering of the spinal cord

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Contrast Similarities and Differences

• Acquired spinal cord impairments
• psychosocial acceptance and development
• physical and motor development
• Congenital impairmentsspina bifida
• psychosocial acceptance and development
• physical and motor development

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Polio

• Incidence
• Cause
• Salk vaccine
• Postpolio syndrome

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Fitness and Spinal Cord Injuries

• Obesity
• General level of fitness?
• Emphasis
• flexibility
• strength
• endurance
• Dealing with muscle imbalances
• Brockport Physical Fitness Test

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Fitness and Safety

• Hypotension
• Thermoregulation
• Autonomic dysreflexia

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Posture Screening

• Role of physical educators
• Screening tools
• posture grid
• Iowa posture test
• New York State Posture Rating Test
• Coordination with other personnel

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Spinal Column Deviations

• Scoliosis
• Kyphosis
• Lordosis
• Spondylolysis and spondylolisthesis

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Classifications

• Classification
• structural
• nonstructural
• Causes
• idiopathic
• neuromuscular
• Incidence

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Scoliosis

• S-shaped curves
• primary
• compensatory
• C-shaped curves
• Treatment
• nonstructural
• structural
• braces

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Treatment of Spinal Deviations

• Establish policies and procedures.
• Work on both strength and flexibility.
• Make routines fun and motivating.
• Employ appropriate warm-up and cool-down periods.
  
• Emphasize static over dynamic stretching.
• Integrate programs into the regular physical
  education program.
• (continued)

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Treatment of Spinal Deviations (continued)

• Make sure students understand and can do the
  exercises correctly.
• Encourage students to watch themselves in mirrors
  when they exercise.
• Make sure program is followed outside physical
  education
• Emphasize symmetrical exercises.
• Be aware of limitations imposed by braces.

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Orthotic Devices

• AFOs
• KAFOs
• HKAFOs
• Canes, walkers, and crutches
• Wheelchairshospital vs. sport chairs

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Inclusion

• Focus on abilities.
• Inclusion is a two-way street.
• Substitute objectives Wheelchair skills for
  locomotor skills.
• Make decisions based on assessment data.
• Make accommodations to ensure . . .
• success
• learning
• Teach self-advocacy.

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Sports

• Opportunities
• events
• levels of competition
• Organizations
• Wheelchair Sports, USA
• Formally National Wheelchair Athletic Association
• Disabled Sports USA
• Formally National Handicapped Sports

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Wheelchair Basketball

• NWBA classification system
• Class I T7 and above
• Class II T8L2
• Class III L3 and below
• Team rules
• 5 players
• Total of 12 points on the floor
• No more than three class III players