PP0314 - Week Four

Go to the Physiotherapy Management of Spinal Cord Injuries

Go to the Pre-Course Activities

Go to the Course Activities


Introduction

In case you missed it here is the week four email.

Task 1: Strength (0.5 hour)

The first task this week is to complete online lesson on Strength. This lesson includes only 4 short activities which are linked to below:[1]

Includes:

The aim of this lesson is to provide an overview of the assessment and treatment of poor strength in people with SCI. Participants will learn about common examples of where strength imposes activity limitations and participation restrictions.

At the end of this lesson, participants will be able to:

  • list some common ways to assess strength
  • identify some examples of where weakness imposes activity limitations and participation restrictions
  • list the key principles important for effective strength training
  • outline an appropriate program for increasing strength in people with tetraplegia and paraplegia

Task 2: Contracture (0.5 hour)

Next you should complete online lesson on Contracture. This lesson includes 6 activities which are linked to below:Complete online lesson - Contracture: assessing and treating

Includes:

The aim of this lesson is to provide an overview of the assessment and treatment of contractures for people with SCI. Participants will learn about common examples of where contractures impose activity limitations and participation restrictions.

At the end of this lesson, participants will be able to:

  • list some common ways to assess contractures
  • identify some examples of where contractures impose activity limitations and participation restrictions
  • list the key principles important for effective contracture management
  • outline an appropriate program for treating and preventing contractures

Task 3: Motor skills (0.5 hour)

Motor skills.  This lesson includes only 5 short activities which are linked to below:

Includes:

The aim of this lesson is to provide an overview of the assessment and treatment of motor skills in people with SCI. Participants will learn about common examples of where lack of skill results in activity limitations and participation restrictions.

At the end of this lesson, participants will be able to:

  • list some common ways to assess motor skills
  • identify some examples of where people with SCI need to learn new motor skills
  • identify some examples of where poor skill imposes activity limitations and participation restrictions
  • list the key principles important for effective training of motor skills
  • outline an appropriate program for improving motor skills

Task 4: Suggested reading (0.5 hour)

Read some or all of the following (as time permits):

Task 5: Create an Exercise Program (0.5 hour)

This activity is designed to help you learn how to create exercise booklets for your patients using the FREELY available website - www.physiotherapyexercises.com

Imagine that you have a patient with paraplegia or C6 tetraplegia and you need to create an exercise program for him/her to improve strength and/or prevent contractures.

Using www.physiotherapyexercises.com create an exercise program for your patient and post it on FaceBook.

You may need to spend 20 minutes learning how to use the website first (see instructions below and video).

You should post your exercise booklet as a URL link (eg. www.physiotherapyexercises.com/ExerciseRender.aspx?Method=Html&RecordIds=481:449:312:524:531&CustomSort=True&TextTitleIds=2:3:4:5:6:7&DropdownTitleIds=-1&Lang=English&ImageType=1&Condition=Pa&Age=AD&Orientation=?


Here are some simple instructions:

  1. Go to www.physiotherapyexercises.com
  2. Click "enter here" in the middle of the page
  3. Use the left menu bar to refine your search
  4. Click in the middle of exercises you like
  5. Go to the top menu bar and click on the icon that says - "view in html format". Click here to see.
  6. Copy the URL and post it in FB. Click here to see.
  7. Make sure you also tell your colleagues who the exercise booklet is appropraite for
  8. You can also save your exercise booklet as a PDF or Word document so that you can include it in your CPD or CE portfolio as evidence of learning.

This short video gives you a quick demonstration for those who want to save and change exercise booklets in word or PDF format:

Task 6: Facebook Discussion (0.5 hour)

Go to the Facebook group for all online discussions.

There are 4 main discussion threads for this week. They are:

1. Passive movements and stretch. What do you think about the routine administration of passive movements? What does the evidence say about passive movements? To whom and when would you routinely administer passive movements? Which joints do you think physiotherapists should focus on? What is the rationale for passive movements? Should we question the effectiveness of passive movements? If so, why? Are there any other ways to prevent joint stiffness and contracture? What do you think about the administration of stretch for the treatment and prevention of contracture? What does the evidence say about stretch? What do you think is the most effective way to prevent and treat contracture in people with SCI?

2. Strength. What should physiotherapists consider when designing strength training programs? Why is it sometimes difficult to fully adhere to what we know about effective strength training? Is a diluted strength training program better than nothing? Do strength training programs need to be continued indefinitely and if not, why not?

3. Motor skills: How can physiotherapists ensure that patients get sufficient repetitious practice? What are some of the difficulties in achieving this? How can physiotherapists ensure patients remain motivated? What makes interesting and motivating exercise regimes? How would we feel if asked to repeat the same exercises over and over again? What would help us continue to do this? How does the attitude and approach of the therapist influence patients' willingness to comply? Does technology appeal to patients? If we use technology then what do we need to be careful about? How important is it that patients practice "ideal" movement strategies? What if they practice some deviation of the ideal movement strategy? Will this hinder recovery?

4. Exercise program: Post the URL for the exercise program that you created in Task 5 on Facebook. Tell us who the exercise program is appropriate for.

Feel free to start your own discussion thread as well. You can post any question or comment related to what you have learnt this week.

Optional: Other Resources and Activities

The following resources are optional for you to read/view but will further expand your knowledge on this week's topics:

  • Read some or all of the references provided at the end of each online lesson you have done this week. Click here or here or here to access.
  • Look at a video of a home shoulder exercise program recommended by a US physiotherapist. Click here to access.
  • Look at videos of people with SCI performing different motor skills. Click here to access.
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Management of Spinal Cord Injuries 

This is the course textbook which will be available to all participants of the course for FREE for the duration of the course.

Access the book here!

Alternatively you might be interested in keeping your own copy of the book.

Buy with 20% discount by clicking here!! (if you have trouble getting a delivery to your country please let us know and we can help)

Purchase E-book

Checklist for the week

1. Completed the following lessons within the physiotherapy-specific module on www.elearnSCI.org:

  • Strength
  • Contracture
  • Motor skills

2. Read part of 3 chapters of the course textbook and 1 journal article

3. Create an exercise program using www.physiotherapyexercises.com

4. Contributed to the Facebook discussion

5. Looked at additional resources (optional)