Spinal Cord Injuries

Created By: Julianna Nania Spinal Cord Injuries

What is SCI? • SCI – Spinal Cord Injuries • Spinal cord is, “The major bundle of nerves carrying impulses to and from the brain to the rest of the body. Rings of bone, called vertebrae, surround the spinal cord. These bones constitute the spinal column or back bones.” • Causes: • Can be congenital: • Polio or Spina Bifida • Can be acquired: • Car accidents, sports injuries, sometimes arthritis • SCI statistics

What is SCI? (Continued) • Anatomy of the Spine: • The spine consists of 33 vertebrae, including the following: • 7 cervical (neck) • 12 thoracic (upper back) • 5 lumbar (lower back) • 5 sacral* (sacrum--located within the pelvis) • 4 coccygeal* (coccyx--located within the pelvis)

Motor Characteristics • Complete • Total lack of sensory and motor function below the level of injury • Quadriplegic • Incomplete • Spinal cord still has the ability to convey messages to and from the brain is not completely lost • Some movement and sensation is still possible below the level of injury

Motor Characteristics (Continued) • Classifications: • Quadriplegia- all four limbs are affected • Loss of movement and sensation • Occurs at T1 or above • Also affect breathing and chest muscles • Paraplegia- 2 limbs are effected (legs) • Loss of movement and sensation • Occurs at T1 and below • Triplegia- 3 limbs are affected (one arm and two legs) • Loss of movement and sensation • Results from incomplete SCI

Secondary Impairments • Muscle weakness • Loss of feeling in the trunk, arms, or legs • Muscle spasticity • Breathing problems • respiratory infections • Problems with heart rate and blood pressure • Digestive problems • ulcers • Pressure Soars

Cognitive Characteristics • If an accident happens and SCI occurs: • “25% to 57% of persons with SCI might have a concomitant traumatic brain injury” • “Difficulties with attention, concentration, memory, problem solving, abstract reasoning, new learning, and high-level cognitive skills” • Will have to go through rehabilitation for memory if traumatic brain injury occurs with SCI. • Learn basic skills such as eating, talking, processing, along with physical movement • If born with SCI cognitive functions are usually normal unless born with a cognitive disability as well

Social Characteristics • Can be very social still with SCI • SCI students can educate friends or family • SCI students can ask for help or inform their friends/family if they can do things independently • Paraplegic can be independent and social in a wheelchair • Play sports such as wheelchair basketball, sit volleyball, modified skiing, etc. • Quadriplegic will be dependent on many people due to the lack of movement in their body

Physical Fitness • Quadriplegic • will not be able to physically exercise on their own • Respiratory fitness • Beat-boxing • Functional Electrical Stimulation (FES) Exercise • Paraplegic- • Lower body is affected with physical exercise • Can still use upper body • Lifting Weights • Wheelchair pushing • Wheelchair aerobics • Swimming • Hand cycling

Physical Fitness (Continued) • Area’s of fitness Affected- • Cardiovascular conditioning • Muscle strength • Muscle endurance is • Stretching for flexibility

Specific Recommendations for Activity • Arm bicycles • Rowing Machines (Wheelchair accessible) • Weight lifting • Free weights • Stretching • Reduces spasticity in the muscles • Sports • Wheelchair Tennis • Wheelchair Basketball • Power chair Soccer • Find these activities through a local gym (weight lifting), yoga programs • Special Olympics

Specific Instructional Recommendations • Respect SCI student’s personal space- teacher and other students • Only touch wheelchair if student asks for help • Lower nets for students in wheelchairs • Students without SCI can play on their knees • Larger Ball • Volleyball – Omnikin ball • Softball • Use a tee, put bases closer together

Contraindicated Activities • No activities that will cause further damage to the spine • Protective wheelchairs for certain sports • Wheelchair basketball • Powerchair Soccer • Only do what is comfortable • Know what their body can handle • Ex: when lifting

Credible On-Line Resources • National Spinal Cord Injury Association • Support groups • Part of their Mission: “We provide active-lifestyle information, peer support and advocacy that empower individuals to achieve their highest potential in all facets of life.” • http://www.spinalcord.org/ • American Spinal Cord Association • Provides a professional Journal about spinal cord injuries • Provides research all about spinal cord injuries • Holds annual meetings • http://www.asia-spinalinjury.org/index.php

Game/Activity • Chair Volleyball • Adapted Volleyball for students with Spinal Cord Injuries • Quadriplegic (upper body) • Students in wheelchairs can stay in wheelchair • Rules: • Buttocks remains in chair at all times • Net is the same height as normal or can be brought down • 3 touches per side • Goal is the same as normal volleyball • Rally scoring • 6 folding chairs per side • Beach ball • http://www.youtube.com/watch?v=IMZj7cv8xeI

Resources • Ann, M. Warren, J., Pullins, & T., Elliott (2008). Concomitant Cognitive Impairment in Persons with Spinal Cord Injuries in Rehabilitation Settings. Retrieved from http://people.cehd.tamu.edu/~telliott/documents/Warren-Pullins-Elliott%20chapter%20edited%202008.pdf • http://www.cnn.com/HEALTH/library/spinal-cord-injury/DS00460.html - CNN Health • http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.4514603/- Christopher and Dana Reeve Foundation • http://www.webmd.com/pain-management/pain-management-spinal-cord-injury-medref - WebMD • http://www.hopkinsmedicine.org/healthlibrary/conditions/physical_medicine_and_rehabilitation/spinal_cord_injury_85,P01180/- John Hopkins Medicine • http://sci.washington.edu/info/forums/reports/universal_fitness.asp#cardio – Northwest Regional Spinal Cord Injury System • http://www.ncpad.org/111/860/Spinal~Cord~Injury~and~Exercise -NCHPAD • http://dsp.berkeley.edu/TeachStudentsWithDisab.html - Berkeley University of California, Disabled Students’ Program • http://www.auburn.edu/~brocksj/4360hastietext/brock02_final.pdf -Auburn University • http://webpages.shepherd.edu/TDARNL01/volleyball.htm - Chair Volleyball

Spinal Cord Injuries