Spinal cord injury assessment

Physiotherapy assessment of spinal cord injuries

1. PHYSIOTHERAPY ASSESSMENT OF SPINAL CORD INJURIES DR. DEEPAK ANAP ASSOCIATE PROFESSOR

2. OBJECTIVES At the end of lecture student should be able to assess a spinal cord injury patient under following headings Pain Range of motion Muscle Performance Reflexes Aerobic capacity / Endurance Arousal, Attention and cognition Gait, Locomotion and balance Motor Function, Self care and Home Management Ventilation and Integument 2

3. PAIN ASSESSMENT Visual Analogue Scale International Spinal Cord Injury Basic Pain Data Set Wheelchair users Shoulder Pain index 3

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5. RANGE OF MOTION Goniometer 5

6. Muscle Performance ASIA ISNSCI Manual Muscle Test Hand Held Dynamometer 6

7. Motor: how do you test each segment ? 7

8. 8 Sensory: how do you determine the level? The sensory levels are scored on a 0 to 2 scale for each dermatome. If body is divided into two identical halves there are 28 key sensory points to be tested. Each dermatome is tested for light touch and pinprick sensations and labeled as NT (not testable) if cannot be tested.

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10. 10 Reflexes Deep Tendon Reflexes Arm Bicipital: C5 Styloradial : C6 Tricipital : C7 Leg Patellar: L3, some L4 Achilles: S1

11. Pathological reflexes 11 Babinski (UMN lesion) Hoffman (UMN lesion at or above cervical spinal cord) Clonus (plantar or patellar) (long standing UMN lesion)

12. AEROBIC CAPACITY /ENDURANCE A 6 min Arm Test 12

13. AROUSAL, ATTENTION AND COGNITION Mini Mental Scale Examination Montreal Cognitive Assessment 13

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15. ENVIROMNETAL OR WORK BARRIERS GAIT, LOCOMOTION AND BALANCE Wheelchair Skill test Modified functional Reach test Berg Balance scale Walking index for spinal cord injury Spinal Cord injury Functional ambulation Inventory 10 meter walk test 6 min walk test Neuromuscular Recovery scale 15

16. Walking Index for Spinal Cord Injury (WISCI II) 16

17. Motor Function Modified Ashworth scale Spinal Cord injury spasticity Evaluation tool 17

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19. SELF CARE AND HOME MANAGEMENT Functional Independence Measure spinal cord injury independence measure Quadriplegia Index of function Capabilities of upper extremity instrument 19

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21. VENTILATION Chest circumference with measure tape Vital capacity Respiratory Rate 21

22. INTEGUMENT Braden Scale Spinal Cord injury pressure Ulcer scale Spinal Cord injury pressure ulcer scale - Acute 22

23. BRADEN SCALE FOR PREDICTING PRESSURE ULCER 23 Scoring: The Braden Scale is a summated rating scale made up of six subscales scored from 1-3 or 4, for total scores that range from 6-23. A lower Braden Scale Score indicates a lower level of functioning and, therefore, a higher level of risk for pressure ulcer development. A score of 19 or higher, for instance, would indicate that the patient is at low risk, with no need for treatment at this time. The assessment can also be used to evaluate the course of a particular treatment.

24. WORK COMMUNITY AND LEISURE INTEGRATION OR REINTEGRATION Craig Handicap Assessment and Reporting technique Assessment of life habits Reintegration to Normal living index 24

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26. 26 Thank you