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LEARNING OBJECTIVES
Identify the major etiologic factors associated with traumatic spinal cord injury.
Describe the clinical presentation following damage to the spinal cord.
Given a patient with a spinal cord injury, identify the motor and sensory level of injury and the American Spinal Injury Association Impairment Scale classification.
Analyze the impact of complications associated with spinal cord injury on the physical therapy plan of care and outcomes.
Identify the expected functional outcomes for patients with spinal cord injury at various lesion levels.
Explain how common precautions will affect physical therapy interventions.
Evaluate different outcome measures commonly used in people with spinal cord injury.
Analyze and interpret patient data, formulate goals and expected outcomes, and develop a plan of care when presented with a clinical case study.
Justify the selection of different interventions for the acute and active rehabilitation stages of recovery.
Discuss the use of neurotechnologies for people with spinal cord injury.
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Spinal cord injury (SCI) is a relatively low-incidence, high-cost injury that results in tremendous change in an individual's life. Paralysis or paresis of the muscles below the level of the injury can lead to limited and altered mobility, self-care, and ability to participate in valued social activities. In addition to the neuromuscular and musculoskeletal systems, many other body systems are impaired after an SCI, including the cardiopulmonary, integumentary, gastrointestinal, genitourinary, and sensory systems. The psychosocial impact of SCI can be just as great as the physical impact. Changes in body image and sexual function, incontinence, and having to rely on others to assist with the completion of everyday tasks that were previously done without thought or effort can profoundly influence a person's identity. Physical rehabilitation is an important component of the recovery process that helps people with SCI achieve a fulfilling and active life after their injury. Wellness and prevention strategies are critical so that individuals with an SCI can age successfully and lead meaningful lives. Physical therapists play a key role in supporting people with SCI during the rehabilitation process and afterward.
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DEMOGRAPHICS AND ETIOLOGY
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It is estimated that approximately 18,000 new cases of SCI occur in the United States annually,1 while the global incidence of traumatic SCI is approximately 800,000.2 The prevalence of SCI in the United States varies, with estimates ranging from 300,0001 to over 2 million.3 The average age at injury is 43 years.1 Although the average age of a person who sustains a SCI has been increasing, approximately 50% of all SCIs occur in individuals between the ages of 16 and 30 years, with the most common age at injury being 19 years. The majority of persons with SCI are male (80% male versus 20% female) 1 Approximately 25% of SCIs occur in non-Hispanic blacks and 13% in individuals of Hispanic ethnicity.
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SCIs can be grossly divided ...