PP0314 - Week Two

Introduction

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

Task 1: Assessment (0.5 hour)

The first task this week is to complete online lesson, Assessment. This lesson includes only 3 short activities which are linked to below:

The aim of this lesson is to provide an overview of a physiotherapy assessment for a person with SCI. Participants will learn the different aspects of a comprehensive assessment and the different types of assessments commonly used by physiotherapists in SCI.

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

  • explain the importance of a comprehensive assessment
  • identify some common ways of assessing impairments, activity limitations and participation restrictions
  • describe the steps involved in performing an assessment

Task 2: Setting goals (0.5 hour)

Next complete online lesson, Setting Goals. This lesson includes 4 short activities which are linked to below:

The aim of this lesson is to provide an overview of the goal setting process for people with motor complete SCI. Participants will learn about the key muscles innervated at each level of injury and how this impacts on physical functioning.

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

  • identify the key muscles innervated at different levels of SCI
  • define the difference between C5 and C6 tetraplegia
  • set short and long term goals for people with complete SCI which are specific, measurable, attainable, realistic, time bound (SMART) and important to the patient
  • list some of the key variables affecting outcome
  • describe the likely level of independence and mobility of people with different levels of SCI

Task 3: Upper limb function (0.5 hour)

Next complete online lesson, Upper limb function: understanding movement. This lesson includes 4 activities which are linked to below: 

The aim of this lesson is to provide an overview of the implications of different patterns of upper limb paralysis on upper limb function. Participants will learn about the hand and upper limb function of people with different levels of tetraplegia.

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

  • describe the hand and upper limb function of people with motor complete C4 to C8 tetraplegia
  • list the key determinants of a tenodesis grip
  • identify common impairments preventing learning of upper limb motor tasks
  • name some of the common measures of hand function

Task 4: Wheelchair mobility (0.5 hour)

Next complete online lesson, Wheelchair mobility: understanding movement. This lesson includes 4 activities which are linked to below:  

The aim of this lesson is to provide an overview of how people with SCI mobilise in a manual and power wheelchair.

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

  • identify the key features of wheelchairs
  • describe how wheelchair set up can influence posture and function
  • list some of the skills essential for mobilising in a power and manual wheelchair
  • understand the mechanics of performing a wheel stand
  • apply the principles of motor learning when teaching patients wheelchair skills

Task 5: Suggested reading (0.5 hour)

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

Task 6: Discussion (0.5 hour)

Go to the Facebook group for all online discussions.

There are 3 main discussion threads for this week. They are:

1. Tell us about an assessment that you could use with people with SCI. Find out about an assessment which you read about this week but know little about. Write a short description about the assessment and direct your colleagues to somewhere that they can find more information. The assessment might be a generic assessment or it might be specific to SCI. Lets see how many different entries we can get about all the many different types of assessments that a physiotherapist might use.

2. Think about the process of setting goals for people with SCI. What do you think might be some of the challenges of setting realistic goals? How do we know what is realistic to expect? Where should we be looking for guidance on this? Where are patients getting information about what to expect? Is this information accurate? What if your patient is not realistic? How should a physiotherapist balance his/her own pragmatic desire to get the patient independent with a patient’s need for hope? Does the media excitement and scientific interest in neural plasticity and technology influence our patients’ expectations about walking? What responsibilities do we as a profession have in ensuring patients are not all led to believe that they will all walk again? Can you find any examples on the web that might give patients the impression that we now have a cure for SCI?

3. Think about hand splints for people with tetraplegia. What are some of the different types of hands splints prescribed for people with tetraplegia? Post a photo from the web of a hand splint you have found. Tell us whether you think the splint would be appropriate and if so, under what conditions? Alternatively, ask your colleagues for their opinion about the splint you found. Tell us what your teachers have taught you about hand splints. Do all spinal units use hand splints? Who usually prescribes and makes hand splints?

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 or here to access.
  • View a video about the optimal way to setup a wheelchair to minimise stress on the shoulders. Click here to access.
  • Look at some of the many gadgets that people with SCI use to overcome problems associated with poor hand function. Click here to access.
  • Look at a powerpoint presentation from a physiotherapist about shoulder pain following SCI. Click here to access.
  • Look at some of the educational material provided to patients about preserving the shoulders. Click here to access or here or here. But there are many more. Have a look for yourself. 
  • Read about a very comprehensive wheelchair skills training program here.
  • Search for all types of physiotherapy-related assessments on the one website. Click here to access.
  • Quickly find SCI-specific outcomes measures for participation and quality of life. Click here to access.
  • Read some more about upper limb surgery for people with tetraplegia. Click here to access.
  • Look at a publication by WHO for guiding wheelchair prescription in low and middle income countries. 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:

  • Assessment
  • Setting goals
  • Upper limb function
  • Wheelchair mobility

2. Read part of 2 chapters of the course textbook and an additional article

3. Contributed to the Facebook discussion

4. Looked at additional resources (optional)