Luke E. Kelly chapter 16 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

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

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 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 Postpolio 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 physical education Emphasize symmetrical exercises. Be aware of limitations imposed by braces.

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

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.

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

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