spinal cord injury in sports

1. SPINAL CORD INJURY (SCI)
#2013

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. 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. 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. 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. 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. 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. 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. 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. (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. 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. 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. 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. Rehabilitation of Spinal Cord Injuries using Locomat robotic treadmill
training.
Spine braces for rehabilitation

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. 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.

18. “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 )

19. “ 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 )

20. •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.

24. Wheelchair basketball
Wheelchair football
Wheelchair rugby
Wheelchair racing
Wheelchair fencing
archery
Badminton wheelchair
Volleyball sitting

25. 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.

26. 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.

27. 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

29. •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.

30. 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.

31. 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.

32. 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

33. 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.