Introduction[edit | edit source]Spinal cord injury (SCI) rehabilitation occurs in different stages and may take weeks, months, or even years. Rehabilitation can start as early as inpatient therapy while preventing and managing medical complications. Initial therapy includes maximizing independence with basic activities such as dressing, bed mobility, wheelchair management and transfers. Further rehabilitation includes training of caregivers, wheelchair seating, and progressive gait retraining if applicable. Education regarding medical complications, pressure relief, as well as bladder - and bowel management, is also an essential aspect of the rehabilitation process.[1] Show
Bed mobility and transfers are extremely important functional activities that individuals with a spinal cord injury need to master for independent mobility and QoL. The level of the spinal cord injuryand whether or not the injury is complete or incomplete is directly associated with the individual’s ability to perform certain functional activities. The knowledge of the specific motor functions attainable at each level of spinal cord injury is important for therapists to work towards and when setting goals. Bed Mobility and Transfers[edit | edit source]
Bed Mobility & Transfers[edit | edit source]1. Rolling[edit | edit source]Importance[edit | edit source]
Sub-tasks[edit | edit source]
Individuals with SCI are required to use their head, neck, and upper limbs to generate momentum in order to roll because of the paralysis in their LLs and/ or trunk Modifications for individuals with C6 tetraplegia[edit | edit source]Individuals with C6 tetraplegia will require to modify their technique due to paralysis of the triceps. They rotate the shoulders externally to keep elbows extended. [3] 2. Mobilising from Supine to Long Sitting[edit | edit source]Importance[edit | edit source]
Sub-tasks[edit | edit source]
Modifications for individuals with C6 tetraplegia[edit | edit source]Individuals with C6 tetraplegia will require to modify their technique due to paralysis of the triceps and inability to straighten their ULs as they push themselves up into sitting. They will walk on the elbows towards their LLs and pull themselves into sitting. [4] 3. Unsupported Sitting[edit | edit source]Importance[edit | edit source]
Unsupported sitting can either be short sitting with legs over the edge of the bed or long sitting with legs straight. Modifications for individuals with C6 tetraplegia[edit | edit source]Individuals with C6 tetraplegia may have to modify their technique when supporting themselves with their upper limbs by externally rotating shoulders and locking elbows in extension if tricep function is impaired. Long sitting is often easier for individuals with C6 tetraplegia than short sitting, due to the bigger BOS, but it’s important to position the trunk or COG anterior of the hips. 4. Vertical Lift[edit | edit source]Importance[edit | edit source]
Sub-tasks[edit | edit source]
Sub-tasks for individuals with C6 tetraplegia
This functional activity can be performed in short - and long sitting. 5. Transfers[edit | edit source]Horizontal Transfers[edit | edit source]Importance[edit | edit source]
Sub-tasks[edit | edit source]
Paraplegia: elevate through arms Tetraplegia: place the palms on the lower back and push the pelvis forwards.
Paraplegia: legs down Tetraplegia: legs up (with elbow flexion hook)
One hand on the bed and the other on the wheelchair wheel.
Vertical Transfers[edit | edit source]Importance[edit | edit source]
Sub-tasks
Online Resources[edit | edit source]eLearnSCI.org - Physiotherapists References[edit | edit source]
Which is the most appropriate method to use when moving a patient?The most recognized technique is the use of the stretcher. EMS and stretchers go together like peanut butter and jelly.
Which is the most appropriate method to use when moving a patient from his or her bed to a wheeled stretcher quizlet?The direct carry is used to transfer a patient: from a bed to the ambulance stretcher. In most instances, you should move a patient on a wheeled ambulance stretcher by: pushing the head of the stretcher while your partner guides the foot.
Which technique allows a patient to be moved from sitting in the vehicle to lying supine on a backboard in 1 minute or less?Using the rapid extrication technique, a patient can be moved from sitting in a vehicle to supine on a backboard in 1 minute or less.
Which device should you use to move a seated stable patient who is complaining of neck pain?The Kendrick Extrication Device (shown in Figure 1 with a yellow arrow) is used in the pre-hospital environment to stabilize patients complaining of neck or back pain after car collisions. The KED is a low-flexibility device that is secured to the patient's torso, legs and head to prevent movement.
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