Case Study of a Person With a Spinal Cord Injury. Julie Sinkosky, PT, DPT Magee Rehabilitation Hospital Philadelphia, PA. Question # 1 What is the primary cause of SCI in the United States? Sports Falls Motor Vehicle Crashes Violence.
Julie Sinkosky, PT, DPT
Magee Rehabilitation Hospital
What is the primary cause of SCI in the United States?
Percentage of Injuries by ASIA Classification
23 y/o African American male s/p multiple GSW to abdomen, left elbow, buttocks and left flank on May 30, 2010Initial Evaluation: July 31, 2010
What other pertinent information do you want to obtain from this patient during your subjective interview?
Anticipated D/C plan
Prior level of mobility
Highlights of acute care hospital stay
Expectation for acute rehabilitation GOALS!
* All within TLSO precautions
Neurological Level of Injury = most caudal level at which both motor and sensory modalities are intact on both sides of the body.
True or False?
This patient has an incomplete spinal cord injury.
Presents with absent sensory and motor function at the lowest sacral segments (S4-S5)
Therefore, he is a complete injury, T10 ASIA A.
With a complete SCI at the T10 level, which of the following muscles would be innervated?
Transfers to bed/mat, level/unlevel
Sit to/from supine
Tilt table/standing frame
Balance- dynamic challenges in short/long sitting
Direction of care for caregiver to perform dependent WC management on stairs, curb, ramp
Stair bumping with Jay Protector
Which of the following is a medication commonly used to control spasticity?
Patient’s personal goal…
“I want to walk.”
Admitted July 31, 2010; Discharge September 17, 2010 (~7 weeks)
Attempted to complete family teaching, no family to “teach”, pt reported he planned to go home with a female friend
Ordering of temporary highstrength lightweight MWC with cushion, backrest, and OT bathroom equipment
Ordering of permanent ultralightweight MWC, cushion, and backrest
Following order submission with letter of medical necessity, will take 3-6 months to be receivedD/C plan