SCI

Question 1

the spinal cord

Answer 1

Made out of nerve cells and nerve fibers that resemble a
cable beginning at the base of the brain. It passes through the vertebrae until it reaches the upper level of the lumbar
vertebrae where it branches out.

Question 2

communication pathway

Answer 2

Ensures proper functioning of vital organs and muscle
movement. Brain commands and body sensations are translated into a nervous impulse like an electric current that travels the length of the spinal cord and nerves.

Question 3

diagnosis in emergency

Answer 3

• The Doctor checks for a pulse, the patient’s airway and that they’re breathing.
• Next, they assess the person’s neurologic function by testing the strength and sensation in the patient’s arms and legs. -Obvious weakness or if the patient is not fully awake, means patient is kept in cervical collar and on a spine board until a full imaging assessment can be completed.
• Immobilization of the spine is crucial during the initial assessment, transportation and through surgery to not cause further damage.

Question 4

diagnosis at hospital

Answer 4

• An x-ray, CT or CAT scan will screen to identify fractures and other bony abnormalities.
• An MRI can be used for looking at the spinal cord itself and for detecting any blood clots, herniated discs or other masses that may be compressing the spinal cord.

Question 5

incidence

Answer 5

● Most injuries occur for people between
the age of 16 to 30
● 80% of traumatic SCI are men
● 40-50% of injuries occur because of
motor vehicle accidents
● Global incidence varies between 40 to
80 cases per million people
● This means every year between
250,000 and 500,000 people are living
with a SCI
● Increasing prevalence in high-income
countries

Question 6

high cervical nerves

Answer 6

● Most severe and most common
● Paralysis of arms, hands, trunk and legs
● Unable to speak, cough, or control bowel movements

Question 7

low cervical nerves

Answer 7

● Corresponding nerves that control arms and hands are affected
● May be able to breath on own and speak
● May be able to drive an adapted vehicle

Question 8

high thoracic nerve

Answer 8

● Nerves affect muscles, upper chest, mid-back and abdominal muscles.
● Injuries usually affect the trunk and legs
● Most use a manual wheelchair, standing frame or walking braces
● Can drive a modified car

Question 9

low thoracic nerves

Answer 9

● Nerves affect muscles of the trunk (abdominal and back muscles)
● Usually results in paraplegia
● Normal upper-body movement
● Fair to good control and balance trunk while in the seated position
● Should be able to cough (if abdominal muscles are intact)
● Little control of bowel or bladder, but can manage with alternative
equipment
● Most use a manual wheelchair, standing frame or walking braces
● Can drive a modified car

Question 10

lumbar nerves

Answer 10

● Some loss of function in the hips and legs
● Little control of bowel or bladder, but can manage with alternative
equipment
● Depending on strength in the legs, may need a wheelchair and may
also walk with braces

Question 11

sacral nerves

Answer 11

● Some loss of function in hips and legs
● Little control of bowel or bladder, but can manage with alternative
equipment
● Usually able to walk

Question 12

treatment

Answer 12

-surgery: decompression or internal fixation, instrumentation, and bone grafting for fusion.
-non surgical: physical or occupational therapy, counseling, and use of assistive devices, steroid
infusion can be used during trauma to decrease swelling, immobilization, medication, before or after surgery bracing with collars or halo vest

Question 13

Ryan Strachnitzki

Answer 13

An epidural stimulator was implanted. This device will
send electrical currents to his spinal cord to try to stimulate nerves and move limbs. The implant is programmed with targeted nerves mapped out by surgeons and therapists. After surgery Ryan was able to move both legs and even had some core muscle contractions.
Cons so far: cost ~$100, 000, varying results, doesn’t work for all, travelling cost/time

Question 14

benefits of PA

Answer 14

● People with spinal cord injuries are more at risk for weight gain, changes in cholesterol, high blood sugar and more
● Reasons to start being physically active
○ Become physically fit
○ Weight loss
○ Improved overall health
○ Enjoyment

Question 15

Should include 3 types of exercise

Answer 15

○ Stretching
○ Aerobic
○ Strength Training

Question 16

recommended weekly exercise

Answer 16

● Stretching
○ Yoga
○ Exercise Bands
● Aerobic
○ Hand cycling
○ Rowing
○ Circuit training
○ Swimming
○ Playing wheelchair basketball
● Strength
○ Weightlifting
○ Using resistance bands
○ Yoga

Question 17

ways to adapt PE class

Answer 17

● Adapt the rules
○ Change the rules for the individual or the class to make integration easier
● Change the class size
○ Smaller classes may be easier to integrate
● Consider other options
○ May be appropriate at times for the student to have a individualised plan

Question 18

things to keep in mind

Answer 18

-physical activity should be matched with the individuals needs and abilities (for example: If they were an athlete before their injury or if they are new to physical
activity)
-individuals with spinal cord injuries can’t regulate their body temperature so its important to keep an eye out for signs of overheating
-if they were involved in a sport prior to their accident, try to keep the activities similar to that sport and work your way up to an adapted version
-how much effort the individual is willing to put in, whether they want to compete or just stay healthy

Question 19

modifications as a coach

Answer 19

-make sure to provide a facility that encourages participation
-accessible parking, ramps, and wide frame doors are a couple examples of what
to look for
-also a good idea to remove any obstacles in hallways or in the area of the activity
and avoid slippery surfaces

Question 20

communication

Answer 20

• make sure to discuss any important factors in the individual’s life, for example pain and fatigue, and make sure everyone involved is aware of these restrictions
• be aware and clear of the individual’s expectations in the program or sport
• ALWAYS ask if they need help before jumping in, never assume they need your help and only lend a hand when it is required
• never touch their wheelchair without consent

Question 21

PA

Answer 21

-adapt the activity to the individual and always focus on what they are able to do,
not what they are not able to do
-the leading causes of death among people with spinal cord injuries are chronic
diseases like heart disease and type 2 diabetes which are caused by physical
inactivity
-physical activity plays a critical role in overall health, including mental health

Question 22

resources

Answer 22

• Canadian Paraplegic Association Manitoba

- SCI Action Canada