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17 Cards in this Set
- Front
- Back
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Pediatric Spinal Cord Injury
•More common in __, with increased incidence of vertebral column injury in 10-16 year old boys •Lack of standardized nationwide data base has hampered reporting of pediatric SCI |
males
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Nature of Injury:
•Infant spine: tremendous flexibiltiy relatively large ___ increased chance for C-spine injury (esp. between skull and __) |
head
C1 |
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Nature of Injury:
•Young Child’s spine (2-10 yrs): muscles/ligaments strengthen bones calcify/grow head/torso relationship changes increased chance of injury to ___ |
C5/C6
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Mechanisms of Injury
•Kinematics of Traumatic Injury: Flexion/extension/rotation Axial loading ___ Seen with: falling motor vehicle accidents sports related injuries birth related injuries |
Distraction
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Mechanisms of Injury
•Traumatic (cont): Gunshot wound •Diseases/Conditions Chiari malformations Tumors Transverse myelitis Down Syndrome Stroke Spinal ___ |
stenosis
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Spinal Column Fracture or Not
•Young children tend to suffer soft tissue injury without “true fracture” of spine •This can result in Spinal Cord Injury without Radiographic Abnormality (SCIWORA) •SCIWORA makes up about ___% of all pediatric SCI |
20%
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Acute Care
•Vital signs stabilized •Spinal column needs to be ___ and stabilized Stabilization may require ___ devices such as a Halo brace Internal spinal ___ may be needed |
decompressed
external fixation fusion |
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Assessment of Pediatric SCI Patient
•ASIA score: obtained by assessment of sensation and motor function and used to assign an ASIA Impairment Scale grade |
ok
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PT Role in Acute Care
•Bowel and Bladder Care •Skin Care/___ •ROM •Strengthening |
Positioning
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Physical Therapy Assessment
1) Histories: a. Present illness b. Medical c. Developmental 2) Systems Review: a. CV/Pulmonary b. Integumentary c. Musculoskeletal: ROM, tone, strength, symmetry, posture d. Neuromuscular: functional mobility, balance, transfers, coordination, locomotion 3) Adaptive equipment needs: a. wheelchairs b. bracing: orthotics, KAFOs, HKAFOS, TLSO c. standing equipment: parapodium, standing frame, mobile |
ok
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Common Problems
•Development of joint contractures some contractures are “helpful” •Autonomic Dysreflexia •Spasticity Management PT, Baclofen, BOTOX •Skin Breakdown •Bone ___ |
Density
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Special Concerns for Ped SCI
•Hip Subluxation: rate higher among children with onset of SCI prior to ___ of age |
10 yrs
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Special Concerns for Ped SCI
Scoliosis: incidence of progressive paralytic scoliosis > 98% for patients injured prior to adolescence bracing prior to curvature of __ degrees may delay/prevent surgery Development of rotational deformities in LEs |
20 degrees
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Therapeutic Exercise
•Aerobic/endurance conditioning •Balance/coordination •Body mechanics •Flexibility •Strength, power, endurance training for trunk, neck, limbs and respiratory muscles •Gait/LT •Aquatic therapy |
ok
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Functional ADL
•School and play activities •Transport issues transfers in/out of vehicle transport of wheelchair •Dressing, feeding, bathing, etc. |
ok
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Other Interventions
•___ Electric Stimulation found to improve palmar grasp, increase pinch force and improve manipulation •Partial Weight Bearing Systems |
Functional
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Psychological Outcomes
•Depression/Anger common in ___ with SCI Associated with perceptions re: reduced quality of life PT has potential to impact this by enhancing community-based ___ as well as overall health via cardio-pulmonary conditioning |
adolescents
mobility |
