Spinal cord rehabilitation
Theoretical introduction
Definition
❗ A Spinal Cord Injury (SCI) is damage or trauma to the spinal cord that
results in a loss or impaired function causing reduced mobility or feeling.
→ Paraplegia: impaired function in trunk and lower limbs.
→ Tetraplegia: impaired function in upper limbs, trunk and lower limbs.
Etiology
❗ Spinal collum damaged which pushes on the spinal cord.
Incidence: 1-2/ 100 000.
→ Tendency toward tetra + incomplete!
Tetraplegia/ paraplegia: 50/50.
Complete/ incomplete: 50/50.
Traumatic (75%) versus atraumatic (25%).
Gender: make more traumatic.
Age: elderly more atraumatic.
Spinal cord rehabilitation 1
, Loss of function
Motor function
Sensibility
❗ Touch, pressure, temperature, pain, proprioception and vibration.
Autonomic function
Spinal cord rehabilitation 2
, Spinal cord anatomy
1. Complete or incomplete transaction
= complete loss of function.
= amount of damage depends on anatomy.
2. Posterior versus anterior blood supply problem:
Anterior = motor + pain + light sensation.
Posterior = proprioception + vibration + deep sensation.
3. Central cord problem:
Lost function below the lesion but more downwards it's better.
4. Cauda equina:
Lower motor neuron lesion.
→ Looks more like peripheral motor neuron problem.
Anatomy different than from spinal cord.
Consequences
1. Functionality.
2. Respiratory.
❗ More problems with expiration then with inspiration.
Inspiration:
→ Neck muscles: above C3.
→ Diaphragm: C3 - C5.
Expiration:
→ Intercostal muscles: T1 - T12.
→ Abdominal muscles: T7 - T12.
Spinal cord rehabilitation 3
Theoretical introduction
Definition
❗ A Spinal Cord Injury (SCI) is damage or trauma to the spinal cord that
results in a loss or impaired function causing reduced mobility or feeling.
→ Paraplegia: impaired function in trunk and lower limbs.
→ Tetraplegia: impaired function in upper limbs, trunk and lower limbs.
Etiology
❗ Spinal collum damaged which pushes on the spinal cord.
Incidence: 1-2/ 100 000.
→ Tendency toward tetra + incomplete!
Tetraplegia/ paraplegia: 50/50.
Complete/ incomplete: 50/50.
Traumatic (75%) versus atraumatic (25%).
Gender: make more traumatic.
Age: elderly more atraumatic.
Spinal cord rehabilitation 1
, Loss of function
Motor function
Sensibility
❗ Touch, pressure, temperature, pain, proprioception and vibration.
Autonomic function
Spinal cord rehabilitation 2
, Spinal cord anatomy
1. Complete or incomplete transaction
= complete loss of function.
= amount of damage depends on anatomy.
2. Posterior versus anterior blood supply problem:
Anterior = motor + pain + light sensation.
Posterior = proprioception + vibration + deep sensation.
3. Central cord problem:
Lost function below the lesion but more downwards it's better.
4. Cauda equina:
Lower motor neuron lesion.
→ Looks more like peripheral motor neuron problem.
Anatomy different than from spinal cord.
Consequences
1. Functionality.
2. Respiratory.
❗ More problems with expiration then with inspiration.
Inspiration:
→ Neck muscles: above C3.
→ Diaphragm: C3 - C5.
Expiration:
→ Intercostal muscles: T1 - T12.
→ Abdominal muscles: T7 - T12.
Spinal cord rehabilitation 3
