Spinal Cord Injured Patient

Aka: Spinal Cord Injured Patient, Wheelchair Bound Patient, Wheelchair User, Non-Ambulatory Patient

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II. Definitions

  1. Paraplegia
    1. Complete paralysis of the lower part of the body including the legs
    2. Level of thoracolumbar spine lesion determines deficits
  2. Quadriplegia
    1. Paralysis of all four limbs and trunk
    2. Level of Cervical Spine lesion determines deficits

III. Prevention

  1. See Decubitus Ulcer Prevention
  2. Regular preventive care per age, gender, comorbidity
    1. Spinal Cord Injured Patients have reduced preventive healthcare
      1. Stillman (2014) Arch Phys Med Rehabil 95(6):1114-26 +PMID: 24565745 [PubMed]
    2. Subspecialty care is also reduced for spine injured patients
      1. Lagu (2013) Ann Intern Med 158(6):441-6 +PMID: 23552258 [PubMed]
  3. Fall Prevention
    1. Falls are associated with significant morbidity and mortality
    2. Falls typically occur during transfers (e.g. to and from bed or toilet)
    3. Wheelchair locking mechanism should be functional and locked during transfers
      1. Consider automatic locking mechanisms or more sturdy Wheelchair locks
    4. Transfer technique is important (assisted or unassisted)
    5. Independent recovery and assisted recovery techniques (getting back into Wheelchair) are also important
    6. Sutton (2019) Canadian Agency for Drugs and Technologies in Health +PMID: 31545572 [PubMed]
  4. Regular Physical Activity
    1. Improves aerobic capacity, balance, walking ability, Activities of Daily Living and global function
    2. Also improves Major Depression and sleep quality
    3. Selph (2021) AHRQ 21(22): EHC017 +PMID: 34723448 [PubMed]

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