Rehabilitation in Spinal Cord Injuries

1st Edition - February 1, 2020
Authors: Jacqueline E. Reznik, Joshua Simmons
Language: English
Paperback ISBN:
9 7 8 - 0 - 7 2 9 5 - 4 3 2 0 - 0
eBook ISBN:
9 7 8 - 0 - 7 2 9 5 - 8 7 6 0 - 0

Rehabilitation in Spinal Cord Injuries is a practical guide to the treatment and/or management of spinal cord injuries for the physiotherapy student and early career clinician… Read more

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Rehabilitation in Spinal Cord Injuries is a practical guide to the treatment and/or management of spinal cord injuries for the physiotherapy student and early career clinician, as well as the medical and health professional wishing to remain current with advancements in treatment and interventions in this area.

Written by Jacqueline Reznik and Joshua Simmons, this multi-contributor text explores contemporary aspects of spinal cord injury treatment and management, as well as essential but not commonly addressed topics, such as sexual rehabilitation, psychological impacts, improving upper limb function of the tetraplegic patient, and ageing with a spinal cord injury. The patient experience is emphasised throughout with input from individuals who have lived experience of a spinal cord injury.

Offering new and important insights into key facets of spinal cord injury treatment and management, Rehabilitation in Spinal Cord Injuries is a practical, evidence-based resource to support clinicians to provide high-quality care and ensure the best patient outcomes.

Cover image
Title Page
Table of Contents
Copyright
Dedication
Preface
How this book should be used
Foreword
Endorsement by Ida Bromley FCSP
Reference
About the editors
Contributors
Reviewers
Acknowledgements
1 Introduction to spinal cord injury
Introduction and overview
Development from the nervous system
The blood–spinal cord barrier (BSCB)
Cells of the CNS and spinal cord
Spinal cord structure
Spinal cord: systems
Introduction
Overview of injury and cell death
Spinal cord injuries
Summary
References
2 From the field to the emergency department and beyond
Introduction
Epidemiology of spinal cord injury
Epidemiology of emergency responses for potential SCI
SCI management by EMS
Initial assessment and management overview
Special topics in acute spinal cord injury
Summary
References
3 The shifting paradigm
Introduction: Compensation versus recovery
Traditional rehabilitation after spinal cord injuries
The activity-dependent plasticity of the spinal cord
The recovery model: activity-based therapies (ABTs)
Activity-based therapies modalities
Neuromodulation
Summary
References
4 Early hospital management
Introduction
Assessment framework
Relevant history
Respiratory assessment and management
Neurological assessment
Range of motion
Pain
Tone and spasm
Circulation
Skin condition
Osteoporosis
Initial mobilisation
Strengthening
Education
Summary
Online resources
References
5 Biomechanics
Introduction
Definitions used in biomechanics
Standardising a reference frame
Describing and understanding movement (the Laws of Motion)
Balance and stability
Bed mobility
Wheelchair propulsion biomechanics
Summary
References
6 Functional independence
Introduction
Teaching strategies and progression of functional skills
Unsupported sitting
Bed mobility
Transfers
Training of manual wheelchair skills
Early standing
Gait re-education
Objective measures
Education and training
Summary
References
7 Electrotherapeutic techniques
Introduction
NMES parameters, pulse current types and characteristics
Neuromodulation
Manipulation of NMES/FES parameters in people with SCI
Clinical application of NMES/FES in people with SCI
NMES/FES devices
Electrical stimulation to elicit musculoskeletal adaptations
Use of NMES as a muscle strength-training modality
Summary
References
8 Modes of transport
Introduction
Initial assessment
Mobility scooters
Summary
Introduction
How will I know if and when I am ready to return to driving?
What are my alternatives to driving?
How do I return to driving following AN SCI?
What vehicle is best for modifications?
Useful existing features of unmodified production cars
What vehicle modifications are available and what are most suitable?
What other factors do I need to consider in my return to driving after an SCI?
The technology of vehicle modifications
Summary
Online resources
References
9 Ambulation
Introduction
Ambulation/walking
Walking as a functional activity
Traditional gait re-education
New paradigms for gait re-education
Locomotor training for gait re-education
Principles of locomotor training
Robotic exoskeletal gait re-education
Summary
References
10 Hydrotherapy
Introduction
Therapeutic (physiological) effects of exercise in water
Treatment goals
General principles of exercises in water
Hydrotherapy assessment and treatment
Guidelines and standards
Conventional hydrotherapy techniques
Swimming
Specific hydrotherapy techniques
Summary
Online resources
References
11 Incomplete spinal and peripheral nerve lesions
Introduction
Incomplete spinal cord injury (iSCI)
Rehabilitation post iSCI
Summary
References
12 Overview of sexual function and changes post-SCI
Introduction
Basics of human sexuality
Sexuality and disability – the construction of sexuality in people with disability
Sexuality after an SCI
Fertility after an SCI
Treatment aspects – sexual health assessment model
Summary
Online resources
References
13 Exercise and sport
Introduction
Anatomical, physiological and psychosocial consequences of SCI
Exercise guidelines for people with an SCI
Other benefits of exercise and sport for people with an SCI
Considerations for people with an SCI participating in exercise and sport
Summary
Online resources
References
14 Paediatric spinal cord injury
Introduction
Incidence
Causes of SCI in children
Classification
Prognosis
Prevention
Acute setting – preparation for rehabilitation
Early rehabilitation and psychosocial support
Outcome measures
Medical issues within paediatric SCI
Anticipatory guidance
Discharge planning
Schooling
Mobility
Upper limb function
Assistive technology
Musculoskeletal issues
Sports, recreation and leisure
Transition to the adult setting
Summary
References
15 Ageing with a spinal cord injury
Introduction
Trends relating to the natural course of an SCI
Accelerated ageing
Changes in functional ability associated with ageing
Exercise guidelines for the ageing population with an SCI
Summary
References
16 High cervical lesions
Introduction
Initial management
Postural considerations in high CSCI
Quality of life
Safety considerations
Long-term respiratory health
Transitioning to life in the community from hospital
Summary
Online resources
References
17 Improving upper limb function
Introduction
Hand function and principles of therapy in tetraplegia
Management of the upper limb in the acute phase
Interventions in the acute phase
Management of the upper limb in the sub-acute phase
Measurement of upper limb function
Surgical management
Rehabilitation
Outcomes following surgical reconstruction
Tetraplegic upper limb function from the patient's perspective
Summary
Online resources
References
18 Common complications of spinal cord injury
Neurogenic bladder
Complications of NGB
Evaluation of patients with neurogenic bladder
Neurogenic bowel
Summary
Introduction
What is sleep disordered breathing?
Obstructive sleep apnoea
Clinical practice guidelines for the management of OSA in people with an SCI
Summary
Introduction
Pain presentations
Prevalence of pain
Management of pain following SCI
Management of musculoskeletal pain
Management of neuropathic pain
Summary
Introduction
Possible pathophysiological mechanisms
Clinical diagnosis
Laboratory investigations
Summary
Online resources
References
19 Psychological sequelae of spinal cord injuries
Introduction
Historical perspective of conversion disorders
Conversion and somatic symptom disorder
Psychological adaptation to spinal cord injury
Clinical case presentations
Summary
References
20 Sociological issues associated with spinal cord injury – a personal journey
Introduction
Employment
Leisure time
Partners/relationships
Physical intimacy
Changing family relationships
Summary
What happened?
Online resources
References
21 The hazards of living with a spinal cord injury
Introduction
Common themes
Reference
Postface
Appendix 1
Appendix 2
Appendix 3 Modified Ashworth Scale
Equipment Required
Testing Position
Grades
Example
Appendix 4 Tardieu Scale
Equipment Required
Test Procedure
Definitions
Example
Interpretation of Findings
Appendix 5
Appendix 6
Index

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Jacqueline E. Reznik

Joshua Simmons