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chapter 16

chapter 16. Spinal Cord Disabilities. Luke E. Kelly. 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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chapter 16

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  1. chapter16 Spinal Cord Disabilities Luke E. Kelly

  2. 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

  3. 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

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

  5. Treatment Phases • Hospitalization—acute medical treatment • Rehabilitation • adjustment to injury • basic living skills • Return to home or school—transition back to a normal routine

  6. Secondary Issues • Psychological acceptance • Health conditions • decubitus ulcers • bruising • urinary tract infections • spasticity • contractures • obesity

  7. Spina Bifida • Spina bifida classifications • occulta • meningocele • myelomeningocele • Hydrocephalus—shunts • Chiari II malformation • Tethering of the spinal cord

  8. 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

  9. Polio • Incidence • Cause • Salk vaccine • Postpolio syndrome

  10. Fitness and Spinal Cord Injuries • Obesity • General level of fitness? • Emphasis • flexibility • strength • endurance • Dealing with muscle imbalances • Brockport Physical Fitness Test

  11. Fitness and Safety • Hypotension • Thermoregulation • Autonomic dysreflexia

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

  13. Spinal Column Deviations • Scoliosis • Kyphosis • Lordosis • Spondylolysis and spondylolisthesis

  14. Classifications • Classification • structural • nonstructural • Causes • idiopathic • neuromuscular • Incidence

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

  16. 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)

  17. 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.

  18. Orthotic Devices • AFOs • KAFOs • HKAFOs • Canes, walkers, and crutches • Wheelchairs—hospital vs. sport chairs

  19. 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.

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

  21. Wheelchair Basketball • NWBA classification system • Class I: T7 and above • Class II: T8–L2 • Class III: L3 and below • Team rules • 5 players • Total of 12 points on the floor • No more than three class III players

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