Spinal Cord Injury Continuing Education

Course Objectives

Upon successful completion of this course participants will be able to:

• Identify the importance of ASIA testing and the anal-rectal exam.
• Recognize how a diagnosis of a specific level of injury does not necessarily predict the potential for ambulation.
• Identify and discuss the principles and parameters of the recovery model of training.
• Recognize how to identify a very low-level functioning muscle (s) and utilize that minimum level to promote functional movement.
• Recognize that a diagnosis of a specific level of injury does not dictate overall function or lack of function.
• Identify the importance of manual muscle testing in alternate positions in order to elicit function and isolate specific muscle groups.
• Discuss activity-based therapy and identify how to incorporate this into a treatment plan
• Identify the parameters for using an exoskeleton for locomotion
• Identify the parameters for utilizing a harness system when treadmill training for locomotion.
• Discuss the importance of specific long-term training in order to elicit functional mobility.
• Recognize the long-term plan when developing a comprehensive functional rehab program for spinal cord patients.
• Develop programs that focus on full body movement engaging multi-segmental control throughout the phases of varying functional ability.
• Develop programs that enhance movement therapy strategies including task-specific training, activity-based strengthening, and the benefits of neuromuscular re-education.
• Identify how FES, EMG, and robotics can play an important role in locomotion recovery.
• Recognize the national resources available to provide evidence-based research on spinal cord injury.

Learn From the Expert - Selina M. Morgan, PT, DPT

Selina M. Morgan, PT, DPT, graduated from Texas A&M University with a BS in Health Education in 1984, and the University of Texas Health Science Center in Dallas, School of Physical Therapy in 1986. She earned her Doctor of Physical Therapy degree from the University of Texas Medical Branch in 2016. She has been actively involved in the physical rehabilitation of neurological compromised patients and assistive technology throughout her career. She currently serves as the spinal cord injury lead therapist in an outpatient rehabilitation center in San Antonio.

Selina first gained teaching experience through her faculty position at the Texas Tech School of Physical Therapy in 1995. She is an adjunct instructor at The University of Texas Health Science Center at San Antonio, teaching the Management of the Patient with Neurological Dysfunction for the 2nd year doctoral physical therapy students.

Introduction to the Course-Motor Learning

• Rehab of patients following spinal cord injury has dramatically changed over the past several years
• The NeuroRecovery Network
• The principles of motor learning
• Compensation strategy examples
• Recovery strategies
• Good kinematic postural control
• Activity-based therapy (ABT)
• Retraining the nervous system
• Neuromuscular Recovery Scale
• ASIA exam
• incomplete ASIA C injuries
• Medicaid funds and private insurance funds

Case Study: Alyssa a Young Adult Female Who Sustained a C5-7 Spinal Cord Injury in 2008

• 22 year old female who sustained a C5-7 spinal cord injury
• ASIA Impairment Scale-A (AIS-A)
• “Complete” injury such that there is no sensory or motor sparing
• Transfers
• Perform stretching exercises
• Activities of daily living
• The patient’s home environment

Case Study: Alyssa: Dr. Morgan’s Discussion and Demonstration of the Evaluation and Treatment Progression

• What about recovery?
• A new focus in Alyssa’s plan of care
• Full manual muscle test
• Spastic responses
• The spinal cord is capable of learning and capable of generating its own output even if it is functionally independent of the brain
• Using static and dynamic postural control
• A strong focus on full body movement engaging multi-segmental control
• Surface-Electromyography

Case Study: Alyssa: FES (Functional Electric Stimulation), Preparation and Guidelines

• Functional electrical stimulation (FES)
• Upper motor neuron lesions
• Lower motor neuron lesions
• The use of EMG
• The exoskeleton
• Key muscles that need to be stretched

Case Study: Alyssa: Car Transfer and Final Summary

• The Car Transfer
• The remarkable progress of this patient

Case Study: Jordan: Upright and Locomotor Training

• a T12 spinal cord injury during a horseback riding accident
• AIS-A designation during her spinal shock period
• Lower motor neuron L4-5 potential damage
• Eksobionics GT
• The NRN is the gold standard flagship
• Functional electrical stimulation

Case Study: Jordan: Young Adult who Sustained a T-12 Spinal Cord Injury During a Horseback Riding Incident

• Body weight support system is from Biodex
• Research projects that was done by NRN
• Activity-based therapy
• Sensory feedback from the treadmill belt
• Facilitate medial hamstrings and anterior tibialis
• The recovery-model approach to rehabilitation

Course Test - Evaluate your knowledge

• Use the Healthclick proprietary online education system which provides the online student with:
• Worldwide access to high definition video, anatomical animations and images, and written information
• The highest quality film in the industry, you can see the difference!
• Stop and resume within a course, the Healthclick system will optimize your course based on your device, connection and remembers where you left off.
• Real-time course updates. We are always adding to each courses, updating content, adding animations, these are not static courses!
• Evaluate your knowledge with the course test on any device.
• Print your state course certificate for CE credit.
• Take the online test as many times as need in order to achieve a 70 % or greater score.