Spinal cord injury assessment
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Transcript of Spinal cord injury assessment
PHYSIOTHERAPY ASSESSMENT OF SPINAL
CORD INJURIES
DR. DEEPAK ANAP
ASSOCIATE PROFESSOR
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
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PAIN ASSESSMENT
Visual Analogue Scale
International Spinal Cord Injury Basic Pain Data Set
Wheelchair users Shoulder Pain index
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RANGE OF MOTION
Goniometer
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Muscle Performance
ASIA ISNSCI
Manual Muscle Test
Hand Held Dynamometer
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Motor: how do you test each segment ?
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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.
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10Reflexes
Deep Tendon Reflexes
Arm
Bicipital: C5
Styloradial: C6
Tricipital: C7
Leg
Patellar: L3, some L4
Achilles: S1
Pathological reflexes11
Babinski (UMN lesion)
Hoffman (UMN lesion at or above cervical spinal cord)
Clonus (plantar or patellar) (long standing UMN lesion)
AEROBIC CAPACITY /ENDURANCE
A 6 min Arm Test
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AROUSAL, ATTENTION AND COGNITION
Mini Mental Scale Examination
Montreal Cognitive Assessment
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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
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Walking Index for
Spinal Cord Injury
(WISCI II)
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Motor Function
Modified Ashworth scale
Spinal Cord injury spasticity Evaluation tool
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SELF CARE AND HOME MANAGEMENT
Functional Independence Measure
spinal cord injury independence measure
Quadriplegia Index of function
Capabilities of upper extremity instrument
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VENTILATION
Chest circumference with measure tape
Vital capacity
Respiratory Rate
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INTEGUMENT
Braden Scale
Spinal Cord injury pressure Ulcer scale
Spinal Cord injury pressure ulcer scale - Acute
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BRADEN SCALE FOR PREDICTING PRESSURE ULCER
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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.
WORK COMMUNITY AND LEISURE
INTEGRATION OR REINTEGRATION
Craig Handicap Assessment and Reporting technique
Assessment of life habits
Reintegration to Normal living index
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Thank you