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Spinal cord injury assessment

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Spinal cord injury assessment

  1. 1. PHYSIOTHERAPY ASSESSMENT OF SPINAL CORD INJURIES DR. DEEPAK ANAP ASSOCIATE PROFESSOR
  2. 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. 3. PAIN ASSESSMENT  Visual Analogue Scale  International Spinal Cord Injury Basic Pain Data Set  Wheelchair users Shoulder Pain index 3
  4. 4. 4
  5. 5. RANGE OF MOTION  Goniometer 5
  6. 6. Muscle Performance  ASIA ISNSCI  Manual Muscle Test  Hand Held Dynamometer 6
  7. 7. Motor: how do you test each segment ? 7
  8. 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.
  9. 9. 9
  10. 10. 10 Reflexes  Deep Tendon Reflexes  Arm  Bicipital: C5  Styloradial: C6  Tricipital: C7  Leg  Patellar: L3, some L4  Achilles: S1
  11. 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. 12. AEROBIC CAPACITY /ENDURANCE  A 6 min Arm Test 12
  13. 13. AROUSAL, ATTENTION AND COGNITION  Mini Mental Scale Examination  Montreal Cognitive Assessment 13
  14. 14. 14
  15. 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. 16. Walking Index for Spinal Cord Injury (WISCI II) 16
  17. 17. Motor Function  Modified Ashworth scale  Spinal Cord injury spasticity Evaluation tool 17
  18. 18. 18
  19. 19. SELF CARE AND HOME MANAGEMENT  Functional Independence Measure  spinal cord injury independence measure  Quadriplegia Index of function  Capabilities of upper extremity instrument 19
  20. 20. 20
  21. 21. VENTILATION  Chest circumference with measure tape  Vital capacity  Respiratory Rate 21
  22. 22. INTEGUMENT  Braden Scale  Spinal Cord injury pressure Ulcer scale  Spinal Cord injury pressure ulcer scale - Acute 22
  23. 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. 24. WORK COMMUNITY AND LEISURE INTEGRATION OR REINTEGRATION  Craig Handicap Assessment and Reporting technique  Assessment of life habits  Reintegration to Normal living index 24
  25. 25. 25
  26. 26. 26 Thank you

Hinweis der Redaktion

  • 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.

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