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Chapter 16 Spinal Cord Disabilities. C H A P T E R. 16. Spinal Cord Disabilities. Luke E. Kelly. Spinal Cord Disabilities. Common spinal cord injuries Traumatic injuries: tetraplegia and paraplegia Spina bifida Polio Spinal column deviations Scoliosis Kyphosis and lordosis
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Chapter 16 Spinal Cord Disabilities C H A P T E R 16 Spinal Cord Disabilities Luke E. Kelly
Spinal Cord Disabilities • Common spinal cord injuries • Traumatic injuries: tetraplegia and paraplegia • Spina bifida • Polio • Spinal column deviations • Scoliosis • Kyphosis and lordosis • Spondylolysis and spondylolisthesis
Classification and Function • Classification systems • Medical • Sport • Relevant factors • Respiration • Shoulder, arm, and hand control and sensation • Trunk stability • Hip, knee, and ankle control and sensation • Bowel and bladder control • Quadriplegia and paraplegia
Handling Potential Spine Injuries • Treat all possible injuries as serious. • Immobilize neck. • Restore breathing and circulation. • Summon medical help. • Keep victim warm.
Treatment Phases • Hospitalization—acute medical treatment • Rehabilitation • Adjustment to injury • Basic living skills • Return to home or school—transition back to a normal routine
Secondary Issues • Psychological acceptance • Health conditions • Decubitus ulcers • Bruising • Urinary tract infections • Spasticity • Contractures • Obesity
Spina Bifida • Spina bifida classifications • Occulta • Meningocele • Myelomeningocele • Screening and prenatal surgery • Hydrocephalus—shunts • Chiari II malformation • Tethering of the spinal cord
Contrast Similarities and Differences • Acquired spinal cord impairments • Psychosocial acceptance and development • Physical and motor development • Congenital impairments—spina bifida • Psychosocial acceptance and development • Physical and motor development
Polio • Incidence • Cause • Salk vaccine • Post-polio syndrome
Fitness and Spinal Cord Injuries • Obesity • General level of fitness • Emphasis • Flexibility • Strength • Endurance • Dealing with muscle imbalances • Brockport Physical Fitness Test
Fitness and Safety • Hypotension • Thermoregulation • Autonomic dysreflexia
Posture Screening • Role of physical educators • Screening tools • Posture grid • Iowa Posture Test • New York State Posture Rating Test • Coordination with other personnel
Spinal Column Deviations • Scoliosis • Kyphosis • Lordosis • Spondylolysis and spondylolisthesis
Classifications • Classification • Structural • Nonstructural • Causes • Idiopathic • Neuromuscular • Incidence
Scoliosis • S-shaped curves • Primary • Compensatory • C-shaped curves • Treatment • Nonstructural • Structural • Braces
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)
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 of physical education. • Emphasize symmetrical exercises. • Be aware of limitations imposed by braces.
Orthotic Devices • AFOs • KAFOs • HKAFOs • Canes, walkers, and crutches
Inclusion • Focus on abilities. • Inclusion is a two-way street. • Substitute objectives (e.g., wheelchair skills for locomotor skills). • Make decisions based on assessment data. • Make accommodations to ensure success and learning. • Teach self-advocacy.
Sport • Opportunities • Events • Levels of competition • Organizations • Wheelchair and Ambulatory Sports, USA • Disabled Sports USA
Wheelchair Basketball • NWBA classification system • Class I: T7 and above • Class II: T8-L2 • Class III: L3 and below • Team rules • Five players • Total of 12 points on the floor • No more than three class III players