This document provides an overview of spinal cord injury (SCI), including statistics, causes, classifications, complications, and systems affected. It discusses that there are approximately 12,000 new SCI cases per year in the US, with males more likely to sustain injury. SCI can be traumatic or non-traumatic, and is classified by level and completeness of injury. Common complications include respiratory issues, autonomic dysreflexia, skin breakdown, edema, DVT, and temperature regulation problems. Systems like bladder, bowel, sensation and motor function below the level of injury are impacted depending on the severity and level of the lesion.
Presentation during IFNR 2016.
Brief description with available evidence on various coma arousal therapy with an illustrative study for each therapy and recommendation for future.
Presentation during IFNR 2016.
Brief description with available evidence on various coma arousal therapy with an illustrative study for each therapy and recommendation for future.
CASE PRESENTATION - SPINAL CORD INJURY BY HIMANIKAUSHIK - .pptxHimani Kaushik
Spinal cord injury (SCI) is a debilitating neurological condition with tremendous socioeconomic impact on affected individuals and the health care system. Today, the estimated lifetime cost of an SCI patient is $2.35 million per patient. According to the National Spinal Cord Injury Statistical Center, there are 12,500 new cases of SCI each year in North America. More than 90% of SCI cases are traumatic and caused by incidences such as traffic accidents, violence, sports, or falls. The Male-to-female ratio of 2:1 for SCI, which happens more frequently in adults compared to children. Demographically, men are mostly affected during their early and late adulthood (3rd and 8th decades of life) while women are at higher risk during their adolescence (15–19 years) and 7th decade of their lives i.e. age distribution is bimodal, with a first peak involving young adults and a second peak involving adults over the age of 60. Those over 60 years of age who suffer SCI have considerably worse outcomes than younger patients their injuries usually result from falls and age-related bony changes.
PHYSIOTHERAPY MANAGEMENT IN CEREBRAL PALSY.pptxStutiGaikwad5
Physiotherapy management in Cerebral palsy is a vast topic to study and learn so here is a presentation in which all aspects have been tried to be covered. As it is essential for the children with cerebral palsy to be able to function with minimum dependence it becomes important for the therapists along with the caregivers to be aware of all the knowledge about what can be done further for the rehabilitation for this population. All the prerequisites and individual need of each patient might differ with age group and the severity of impairment. So specific goals both long term and short term need to be the focus of treatment planning. Each session requires evaluation and planning skills so to aid the child with the optimum treatment.
Functional Independence Measure (FIM)
Is an 18-item, 7-level ordinal scale
Is designed to assess areas of dysfunction in activities that commonly occur
The scale has few cognitive, behavioral, and communication-related functional items
Is not specific for spinal cord injuries but is designed to assess neurological, musculoskeletal, and other disorders.
constraint induced movement therapy.pptxibtesaam huma
Constraint induced movement therapy
Dr. Quazi Ibtesaam Huma (MPT)
Dr. Suvarna Ganvir (Phd, Prof & HOD)
Dept. of Neurophysiotherapy
DVVPF’s College of Physiotherapy
Content
Introduction
History of CIMT
Components of CIMT
Population for CIMT
Advantages of CIMT
Recent advances
Introduction
History of CIMT
CIMT is based on research by Edward Taub ,his hypothesize that the non use was a learning mechanism and calls this behavior “Learned non-use”.
It was observed that patients with hemiparesis did not use their affected extremity .
Overcoming learned non use
Mechanisms of CIMT
Population for CIMT
Stroke
Traumatic Brain Injury
Spinal Cord Injury
Multiple Sclerosis
Cerebral Palsy
Brachial Plexus Injury
Advantages of CIMT
Overall greater improvement in function than traditional treatment.
Highly researched and credible treatment approach.
There are brain activity and observed gray matter reorganization in primary motor, cortices and hippocampus.
Increase social participation
Components Of CIMT
Types of CIMT
Restraining Tools for CIMT
Minimal Requirement of hand function for CIMT
Recent Advances
The EXCITE Trial: Retention of Improved Upper Extremity Function Among Stroke Survivors Receiving CI Movement Therapy.(2008)
The Extremity Constraint Induced Movement Therapy Evaluation (EXCITE) demonstrated that CIMT administered 3-9 months post-stroke, resulted in statistically significant and clinically relevant improvement in upper extremity function during the first year compared to those achieved by participants undergoing usual and customary care.
This study was the first randomized clinical trial to examine retention and improvements for the 24 month period following CIMT therapy in a subacute sample.
Study design - single masked cross-over design, with participants undergoing adaptive randomization to balance ,gender, prestroke dominant side, side of stroke, and level of paretic arm function across sites.
CIMT was delivered up to 6 hours per day, 5 days per week for 2 weeks.
Subsequent evaluations were made after the two week period, and at 4, 8, and 12 months.
Because the control group was crossed over to receive CIMT after one year.
Primary outcome measures – Wolf Motor Function Test
Motor Activity Log
Secondary outcome measure - Stroke Impact Scale (SIS)
were assessed at each of these time intervals, was administered only at baseline, 4, 12, 16 and 24 month evaluations.
Result :There was no observed regression from the treatment effects observed at 12 months after treatment during the next 12 months for the primary outcome measures of WMFT and MAL.
In fact, the additional changes were in the direction of increased therapeutic effect. For the strength components of the WMFT the changes were significant (P < .05) Secondary outcome variables, including the SIS, exhibited a similar pattern.
Conclusion: Mild to moderately impaired patients who are 3-9 months post-stroke demonstrate
The term Spinal Cord Injury is used to refer to neurological damage of the spinal cord
Any lesion involving the spinal cord result a syndrome called a “myelopathy”
Spinal cord injuries are defined as complete or incomplete according to the International Standards for the Neurological Classifification of SCI and the American Spinal Injuries Association Impairment Scale (AIS)
Complete lesions are defifined as AIS A, and incomplete lesions are defifined as AIS B, AIS C, AIS D or AIS E (Harvey, 2016)
“The ability of neurons to change their function, chemical profile or structure is referred to as neuroplasticity.”
Neuroplasticity includes :
- Habituation
- Learning & memory
- Cellular recovery after injury
Spinal Cord Injuries are uncommon, but they are a leading cause of high cost disability, and with ageing population, the incidence is expected to increase. This presentation looks at the many facets of spinal cord injuries.
Spinal cord injuries complete topic about it and how to make good rehabilitation for the patient with spinal cord injuries .
wish it help people
my pleasure :)
Mostafa shakshak
CASE PRESENTATION - SPINAL CORD INJURY BY HIMANIKAUSHIK - .pptxHimani Kaushik
Spinal cord injury (SCI) is a debilitating neurological condition with tremendous socioeconomic impact on affected individuals and the health care system. Today, the estimated lifetime cost of an SCI patient is $2.35 million per patient. According to the National Spinal Cord Injury Statistical Center, there are 12,500 new cases of SCI each year in North America. More than 90% of SCI cases are traumatic and caused by incidences such as traffic accidents, violence, sports, or falls. The Male-to-female ratio of 2:1 for SCI, which happens more frequently in adults compared to children. Demographically, men are mostly affected during their early and late adulthood (3rd and 8th decades of life) while women are at higher risk during their adolescence (15–19 years) and 7th decade of their lives i.e. age distribution is bimodal, with a first peak involving young adults and a second peak involving adults over the age of 60. Those over 60 years of age who suffer SCI have considerably worse outcomes than younger patients their injuries usually result from falls and age-related bony changes.
PHYSIOTHERAPY MANAGEMENT IN CEREBRAL PALSY.pptxStutiGaikwad5
Physiotherapy management in Cerebral palsy is a vast topic to study and learn so here is a presentation in which all aspects have been tried to be covered. As it is essential for the children with cerebral palsy to be able to function with minimum dependence it becomes important for the therapists along with the caregivers to be aware of all the knowledge about what can be done further for the rehabilitation for this population. All the prerequisites and individual need of each patient might differ with age group and the severity of impairment. So specific goals both long term and short term need to be the focus of treatment planning. Each session requires evaluation and planning skills so to aid the child with the optimum treatment.
Functional Independence Measure (FIM)
Is an 18-item, 7-level ordinal scale
Is designed to assess areas of dysfunction in activities that commonly occur
The scale has few cognitive, behavioral, and communication-related functional items
Is not specific for spinal cord injuries but is designed to assess neurological, musculoskeletal, and other disorders.
constraint induced movement therapy.pptxibtesaam huma
Constraint induced movement therapy
Dr. Quazi Ibtesaam Huma (MPT)
Dr. Suvarna Ganvir (Phd, Prof & HOD)
Dept. of Neurophysiotherapy
DVVPF’s College of Physiotherapy
Content
Introduction
History of CIMT
Components of CIMT
Population for CIMT
Advantages of CIMT
Recent advances
Introduction
History of CIMT
CIMT is based on research by Edward Taub ,his hypothesize that the non use was a learning mechanism and calls this behavior “Learned non-use”.
It was observed that patients with hemiparesis did not use their affected extremity .
Overcoming learned non use
Mechanisms of CIMT
Population for CIMT
Stroke
Traumatic Brain Injury
Spinal Cord Injury
Multiple Sclerosis
Cerebral Palsy
Brachial Plexus Injury
Advantages of CIMT
Overall greater improvement in function than traditional treatment.
Highly researched and credible treatment approach.
There are brain activity and observed gray matter reorganization in primary motor, cortices and hippocampus.
Increase social participation
Components Of CIMT
Types of CIMT
Restraining Tools for CIMT
Minimal Requirement of hand function for CIMT
Recent Advances
The EXCITE Trial: Retention of Improved Upper Extremity Function Among Stroke Survivors Receiving CI Movement Therapy.(2008)
The Extremity Constraint Induced Movement Therapy Evaluation (EXCITE) demonstrated that CIMT administered 3-9 months post-stroke, resulted in statistically significant and clinically relevant improvement in upper extremity function during the first year compared to those achieved by participants undergoing usual and customary care.
This study was the first randomized clinical trial to examine retention and improvements for the 24 month period following CIMT therapy in a subacute sample.
Study design - single masked cross-over design, with participants undergoing adaptive randomization to balance ,gender, prestroke dominant side, side of stroke, and level of paretic arm function across sites.
CIMT was delivered up to 6 hours per day, 5 days per week for 2 weeks.
Subsequent evaluations were made after the two week period, and at 4, 8, and 12 months.
Because the control group was crossed over to receive CIMT after one year.
Primary outcome measures – Wolf Motor Function Test
Motor Activity Log
Secondary outcome measure - Stroke Impact Scale (SIS)
were assessed at each of these time intervals, was administered only at baseline, 4, 12, 16 and 24 month evaluations.
Result :There was no observed regression from the treatment effects observed at 12 months after treatment during the next 12 months for the primary outcome measures of WMFT and MAL.
In fact, the additional changes were in the direction of increased therapeutic effect. For the strength components of the WMFT the changes were significant (P < .05) Secondary outcome variables, including the SIS, exhibited a similar pattern.
Conclusion: Mild to moderately impaired patients who are 3-9 months post-stroke demonstrate
The term Spinal Cord Injury is used to refer to neurological damage of the spinal cord
Any lesion involving the spinal cord result a syndrome called a “myelopathy”
Spinal cord injuries are defined as complete or incomplete according to the International Standards for the Neurological Classifification of SCI and the American Spinal Injuries Association Impairment Scale (AIS)
Complete lesions are defifined as AIS A, and incomplete lesions are defifined as AIS B, AIS C, AIS D or AIS E (Harvey, 2016)
“The ability of neurons to change their function, chemical profile or structure is referred to as neuroplasticity.”
Neuroplasticity includes :
- Habituation
- Learning & memory
- Cellular recovery after injury
Spinal Cord Injuries are uncommon, but they are a leading cause of high cost disability, and with ageing population, the incidence is expected to increase. This presentation looks at the many facets of spinal cord injuries.
Spinal cord injuries complete topic about it and how to make good rehabilitation for the patient with spinal cord injuries .
wish it help people
my pleasure :)
Mostafa shakshak
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
2. SCI Statistics
• Approximately 12,000 new cases of SCI each year
• Causes?
• Males are more likely than females to
sustain an injury.
3. SCI Statistics
• Twenty years post injury, 35.2% are employed with a
similar level of employment through post-injury year
35.
• Lifetime cost varies by level of injury and age at injury.
• Surviving the first 24 hours indicates 85% chance of
survival for 10 years or more.
6. Specific Cord Lesions
• Central cord syndrome- most common,
incomplete, greater weakness in UE than LE,
associated with cervical stenosis
• Brown-Sequard Syndrome- incomplete,
damage to half the cord causing ipsilateral
proprioceptive and motor loss and
contralateral loss of pain and temperature
sensation
• Anterior cord syndrome- absent blood supply
to the cord, loss of motor control, pain, and
temperature sensation below injury,
proprioception and light touch preserved
7. Specific Cord Lesions (con’t)
• Cauda equina Syndrome
• LMN injury to lumbrosacral
roots within spinal canal
• Results in areflexic bladder and
bowel, paralysis or weakness of
lower limbs
• Conus medullaris Syndrome
• In addition to lesions to the
lumbar nerve roots, the spinal
cord is also damaged, resulting
in a mixed physical picture with
some preservation of reflex
activity
• Bladder, bowel, and lower limbs
are also affected.
Both conditions are neurosurgery emergencies!
8. Severity
Depends on:
1. The level of the spinal cord that was affected
2. Whether the lesion is complete or incomplete
Complete Lesion- no sensory or motor function
below the level of the lesion
Incomplete Lesion- characterized by the
preservation of some sensation or motor
function below the level of the lesion.
9. Predictors of Motor Return
• In first 24 hours, predictions are not accurate because
conditions improve or deteriorate
• 72 hours to 1 week after injury- more reliable predictions
• Degree of impairment (incomplete or complete)
• Preserved motor function- best predictor
• Preserved pin prick sensation in sacral region
• Pattern of neurological injury- central cord or Brown-Sequard
better than anterior cord syndrome
• Early neurological return
• Age- younger is better
12. Autonomic Nervous System
• Responsible for control of the bodily functions not consciously
directed, such as breathing, the heartbeat, and digestive
processes.
• Supplies the internal organs, including the blood vessels,
stomach, intestine, liver, kidneys, bladder, genitals, lungs,
pupils, heart, and sweat, salivary, and digestive glands.
13.
14. Sympathetic
• Fight or flight
• Increases heart rate
• Force of heart contractions and dilates the airways to make
breathing easier
• Muscular strength is increased.
• Palms sweat, pupils to dilate, and hair to stand on end.
15. Parasympathetic
• Controls body process during ordinary situations.
• Conserves and restores.
• Slows the heart rate and decreases blood pressure.
• Stimulates the digestive tract to process food and eliminate
wastes.
• Energy from the processed food is used to restore and build
tissues.
17. The ASIA Impairment Scale
To help classify differing degrees of spinal cord injury, the ASIA
Impairment Scale is used to help compare and understand
residual function after a SCI.
18. The ASIA Impairment Scale
Level A Complete No motor or sensory function in the
lowest sacral segment (S4-S5)
Level B Incomplete Sensory function below neurological
level and in S4-S5, no motor function
below level of injury
Level C Incomplete Motor function preserved below injury
level and more than half of the key
muscle groups below neurological
level have a muscle grade <3
Level D Incomplete Motor function preserved below injury
level and at least half of the key
muscle groups below neurological
level have a muscle grade of 3
Level E Normal Sensory and motor function is normal
21. Spinal (Neurogenic) Shock
• Loss of reflexes below lesion immediately after SCI
• Motor pathways lost, causing flaccid paralysis, loss of tendon
reflexes, loss of autonomic function
• Lasts for hours, days, or weeks
• Spinal activity returns
22. Temperature Control
• Many individuals with SCI cannot regulate body temperature.
• SCI causes disruption between hypothalamic temperature
regulators and sympathetic function below lesion
• Lose ability to sweat and shiver
• Poikilothermy- body takes on the temperature of the external
environment; T6 and above
• With lesions above the T6 level, it is important to look out for
signs and symptoms of autonomic dysreflexia.
Resource to check out: http://archive.is/www.apparelyzed.com
23. Autonomic Dysreflexia
• Clinical emergency- can result in death
• Exaggerated sympathetic reflex responses
• Occurs only after spinal shock resolved and autonomic
reflexes return
• Severe hypertension, bradycardia, headache, vasodilation,
flushed skin, profuse sweating above lesion level
• Usually T6 and above
Resource to check out: http://pushliving.com/reviewing-a-d-one-more-time/
25. Autonomic Dysreflexia
1) Stop activity
2) Elevate head to avoid excessive BP to brain
3) Loosen clothing and other constrictions
26. Orthostatic Hypotension in SCI
• Also called postural hypotension
• Blood pressure drops dangerously low when individual with an
SCI at the T6 level or higher is in upright position
• Causes dizziness, pallor in the face, blurred vision, excessive
sweating above lesion, possible fainting
1) Check BP
2) In bed - lower the head of bed
3) In wheelchair - lift legs and if symptoms persist, recline the w/c
to place head at or below heart level.
4) Continue to monitor BP
27. Respiratory Function
With high SCI levels such as C1-C3, the phrenic nerve is
injured and therefore respiratory function is
significantly compromised
28. Edema
• Fluid accumulation in interstitial tissue
• Result of immobility causing increased venous pressure and
pooling of blood in abdomen, upper and lower extremities
29. Skin Breakdown
• Loss of sensation and circulatory changes can compromise
skin integrity.
• Common but preventable complication
• Repositioning is key for pressure relief
30. Deep Vein Thrombosis (DVT)
• Clot in venous system
• Results from impaired vasomotor tone, loss of muscle tone,
trauma to the vein wall, immobility, hypercoagulation
• Can cause pulmonary embolism if clot dislodges and travels to
lungs
31.
32. ReferencesCatz, A., Itzkovich, M., et al. (1997). "SCIM-spinal cord independence measure: a new disability scale for patients with spinal cord
lesions.” Spinal Cord, 35(12): 850-856.
Crepeau, E. B., Cohn, E. S., Boyt-Schell, B. A. (2009) Willard and Spackman’s Occupational Therapy (11th ed.), Wolters Kluwer –
Lippincott Williams & Wilkins.
Guidetti, S., Asaba, E., & Tham, K. (2009). Meaning of context in recapturing self-care after stroke or spinal cord injury. AJOT, 63,
323-332.
Lancaster, S. L. (2014). SCI Powerpoint presentation.
Randomski, M. V., Trombley-Latham, C. A. (2008). Occupational Therapy for Physical Dysfunction (6th ed.), Wolters Kluwer –
Lippincott Williams & Wilkins.
Robertson, E. (2012). SCI Powerpoint presentation.
Ward, K., Mitchell, J., & Price, P. (2007). Occupation-based practice and its relationship to social and occupational participation in
adults with spinal cord injury. Occupational Therapy Journal of Research: Occupation, Participation, and Health, 27,
149-156.
http://www.spinalinjury101.org/details/levels-of-injury
http://www.christopherreeve.org
http://www.disabled-world.com
http://www.spinalcord.uab.edu
http://nm.gov/disorders/sci/sci.htm
http://www.spinalcord.org/life-in-action/
A - Complete: No motor or sensory function in the lowest sacral segment (S4-S5)
B - Incomplete: Sensory function below neurological level and in S4-S5, no motor function below neurological level
C - Incomplete: Motor function is preserved below neurological level and more than half of the key muscle groups below neurological level have a muscle grade less than 3.
D - Incomplete: Motor function is preserved below neurological level and at least half of the key muscle groups below neurological level have a muscle grade 3.
E - Normal: Sensory and motor function is normal
All reflexes cease to function immediately after the injury.