spinal cord injury


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spinal cord injury

  1. 1. SPINAL CORD INJURY (SCI) #2013
  2. 2. INTRODUCTION OF SPINAL CORD INJURY (SCI) 0 Definition 1: 0 According to DD. Cardenas et al. (2002), depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence. 0 According to S. C. Lawrence, (2012), after a suspected SCI, the goals are to establish the diagnosis and initiate treatment to prevent further neurologic injury from either mechanical instability or respiratory insufficiency.
  3. 3. 0 Definition 2: 0 According to A. P. Claudio (2011), the spinal cord is the major bundle of nerves carrying impulses to and from the brain to the rest of the body. It is mean spinal cord is the essential part to create movement in contacts of mobility by humans. 0 Definition 3: 0 In terms of sports conditions, according to Miller, M.D and Sekiya J.K, (2006), the cervical spine injuries in sports are uncommon but can produce significant disability. They most commonly occur in sports resulting in excessive axial loads applied to the head that transmit forces through the cervical spine.
  4. 4. 0 Spinal cord injuries commonly lead to paralysis; they involve damage to the nerves. The spinal cord can be bruised, stretched, or crushed. Thus the spinal cord is coordinates body movement and sensation, an injured may loses the ability to send and receive messages from brain to the body systems that control sensory, motor, and autonomic function.
  5. 5. CAUSES OF SCI • Motor vehicle crashes • Falls • Acts of violence • Sports injuries Traumatic injury • Case of cancer • Infection • Intervertebral disc disease • Vertebral injury • Spinal cord vascular disease • Osteoporosis/arthritis Non- traumatic injury
  6. 6. 0 Direct damage such as contact sport participation has large percentage to get spinal cord injury. This may occurred if the head, neck, or back are twisted abnormally during a collisions. Other than that, risk factors include: 0Participating in risky physical activities 0Not wearing protective gear during work or play 0Diving into shallow water
  7. 7. TYPES OF SCI COMPLETE of SCI • A person loses all ability to feel and voluntarily move below the level of the injury INCOMPLETE of SCI • There is some functioning below the level of the injury
  8. 8. According to American Spine Injury Association (ASIA), (2002), there are five categories on the impairment scale: A :indicates a "complete" spinal cord injury where no motor or sensory function is preserved in the sacral segments S4-S5. B:indicates an "incomplete" spinal cord injury where sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-S5. This is typically a transient phase and if the person recovers any motor function below the neurological level, that person essentially becomes a motor incomplete, i.e. ASIA C or D. C :indicates an "incomplete" spinal cord injury where motor function is preserved below the neurological level and more than half of key muscles below the neurological level have a muscle grade of less than 3, which indicates active movement with full range of motion against gravity. D :indicates an "incomplete" spinal cord injury where motor function is preserved below the neurological level and at least half of the key muscles below the neurological level have a muscle grade of 3 or more. E :indicates "normal" where motor and sensory scores are normal. Note that it is possible to have spinal cord injury and neurological deficits with completely normal motor and sensory scores.
  9. 9. The International Standards for Neurological and Functional Classification of Spinal Cord Injury (ISNCSCI): 0 Tetraplegia (replaces the term quadriplegia): Injury to the spinal cord in the cervical region, with associated loss of muscle strength in all 4 extremities 0 Paraplegia : Injury in the spinal cord in the thoracic, lumbar, or sacral segments, including the cauda equina and conus medullaris.
  10. 10. (ASIA) 0 The percentage of spinal cord injuries as classified by the American Spinal Injury Association (ASIA) is as follows: 0 Incomplete tetraplegia: 29.5% 0 Complete paraplegia: 27.9% 0 Incomplete paraplegia: 21.3% 0 Complete tetraplegia: 18.5% 0 The most common neurologic level of injury is C5. In paraplegia, T12 and L1 are the most common level.
  11. 11. TREATMENT OF SCI Treatment for spinal cord injuries can be divided into two stages: acute and rehabilitation (Stampas, 2013). 0 Acute phase Takes place immediate following the injury and is conducted at a hospital with an appropriate trauma center.Doctor focus on - Maintaining your ability to breathe - Preventing shock - Immobilizing your neck to prevent further spinal cord damage
  12. 12. Type of treatments for SCI 0 Stem Cell Treatment (SCT) - Stem cells are injected in the area of damage in the spinal cord, they secrete neurotrophic factors, and these neurotrophic factors help neurons and vessels grow, thus helping repair the damage. 0 Drug Treatment - Steroid drug methylprednisolone appears to reduce the damage to nerve cells if it is given within the first 8 hours after injury.
  13. 13. 0 Rehabilitation phase Rehabilitation programs combine physical therapies with skill- building activities and counseling to provide social and emotional support.The success of rehabilitation depends on many variables, including the following - Level and severity of the SCI - Overall health of the patient - Family support
  14. 14. Rehabilitation of Spinal Cord Injuries using Locomat robotic treadmill training. Spine braces for rehabilitation
  15. 15. PREVENTION OF SCI 0 Sports prevention tips 0 Use proper protective equipment (well fitting helmet usage in cycling and skateboarding). 0 Wear well-fitting clothing, knee and elbow pads, wrist braces, and gloves. 0 Discard and replace sporting equipment or protective gear that is damaged. 0 Check the depth and check for debris in the water before diving. 0 Do not participate in sports when you are ill or very tired.
  16. 16. General prevention tips 0 - Wear a seatbelt every time you drive or ride in a motor vehicle. 0 - Remove hazards in the home that may contribute to falls. 0 - Never drive while under the influence of drugs or alcohol or ride as a passenger with anybody else who is under the influence. 0 - Use an appropriate shoes/slipper to avoid falls.
  17. 17. “Physical activity is one of the most basic human functions. The human body evolved over millions of years into a complex organism capable of performing an enormous range of tasks, from using large muscle groups to walk, run or climb, to performing detailed actors involving the manual dexterity” (cavil .N, Sonja .Kand Francesca,2006 )
  18. 18. “ physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. Physical inactivity has been identified as the fourth leading risk factorfor global mortality causing anestimated 3.2million deaths globally. “ World Health Organization (2013 )
  19. 19. •According to the National Athletic Trainers’ Association ( NATA ), spinal cord injuries in the United State are estimated at 11,000 new cases each year •football ranking highest in number of injuries for all sports. Doctor from England named Ludwig Guttmann. Ludwig Guttmann also known as the “ Father of Sport for people with Disabilities”. Dr. Guttmann have organized International Wheelchair Games to coincide with the 1948 London Olympics. According official website of the Paralympics movement is, the main factors that determine class in functional classification are how much an athlete’s impairment impacts on sport performance. As a result athletes with lower limb paresis due to spinal cord injury are now able to compete together with double above knee amputees in wheelchair races.
  20. 20. Wheelchair basketball Wheelchair football Wheelchair rugby Wheelchair racing Wheelchair fencing archery Badminton wheelchair Volleyball sitting
  21. 21. Athlete Name : Rick Hansen Cause of spinal cord injury : motor vehicle accident Result of injury : paraplegia ( loss of ability to walk ) Sports competed in after injury : 1 . Track events 2.Road races 3.tennis 4. Basketball 5. Volleyball Achievement :- co-author of 2 books. -Multiple marathon winner and world champion in track. -Raised millions of dollars for spinal research with “ man in motion” tour.
  22. 22. Athlete name : Chantal Petitclerc Cause of spinal cord injury: barn door fell on Petitclerc and snapped her spine. Result of injury : Paralyzed from the hips down. Sports competed in after injury : wheelchair racing Competed in Paralympics Achievement : winner of the Lou Marsh Trophy Canadian athlete of the year.
  23. 23. Athlete name : Bryan Kirkland Causes of spinal cord injury : Motorcycle accident at age 20 Result of injury : Quadriplegic-loss of all four limbs. Sport competed in after injuries : Playing rugby Lifting weights Road races Achievement : Won national in Boston Represented USA at Stoke International Games Bronze Medal in 400m
  24. 24. •Played by two teams •Each team 12 players •Each Team 5 player on the court at one time •4 quarter and 10 minute for each . •15 minute interval between second and third quarter •2 minute in quarter one and four •24 seconds to complete a goal attempt for each team. •The ball and the right play-granted to the opposing team if the team exceed this time limit. •Free throw goal = 1 point •Goal from two point field area=2 point. •Goal from three point field area=3 point. If tied = extra time 5 minute.
  25. 25. Court dimensions: 28 metres (long) x 15 metres (wide) 3 Point line: 6.75 metres (from basket) Basket Height: 3.04 metres (10') •Note : Wheelchair basketball is played on the same court as stand-up basketball (for example the height of the basket, distance to the foul line, three point line, etc. *According International Basketball Federation.
  26. 26. Rules 159 Para 1 Rules 159 Para 2 Rules 159 Para 3 Rules 159 Para 4 The wheelchair shall have at least two large wheels and one small wheel No part of the body of the chair may extend forwards beyond the hub of the front wheel and be wider than the inside of the hubs of the two rear wheels. The maximum height from the ground of the main body of the chair shall be 50 cm. The maximum diameter of the large wheel including the inflated tire shall not exceed 70 cm. The maximum diameter of the small wheel including the inflated tire shall not exceed 50 cm. Only one plain, round, hand rim is allowed for each large wheel. This rule may be waived for persons requiring a single arm drive chair, if so stated on their medical and Games identity cards.
  27. 27. Rules 159 Para 5 Rules 159 Para 6 No mechanical gears or levers shall be allowed, that may be used to propel the chair. Only hand operated, mechanical steering devices will be allowed. Rules 159 Para 7 Rules 159 Para 8 In all races of 800 meters or over, the athlete should be able to turn the front wheel(s) manually both to the left and the right. The use of mirrors is not permitted in track or road races. Rules 159 Para 9 No part of the chair may protrude behind the vertical plane of the back edge of the rear tires. Rules 159 Para 10 It will be the responsibility of the competitor to ensure the wheelchair conforms to all the above rules, and no event shall be delayed whilst a competitor makes adjustments to the athletes chair
  28. 28. Rules 159 Para 11 Chairs will be measured in the Marshalling Area, and may not leave that area before the start of the event. Chairs that have been examined may be liable to re-examination before or after the event by the official in charge of the event. Rules 159 Para 12 It shall be the responsibility, in the first instance, of the official conducting the event, to rule on the safety of the chair. Rules 159 Para 13 Athletes must ensure that no part of their lower limbs can fall to the ground or track during the event.