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

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

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 Causes Incidence Structural Nonstructural Causes Idiopathic Neuromuscular Incidence

Scoliosis S-shaped curves C-shaped curves Treatment 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 Organizations Events Levels of competition 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